Men With Adult ADHD

Improve Concentration, Increase Productivity, and Stop Feeling Like a Failure

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Edgar Wise
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Copyright © 2021 by Edgar Wise

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 Contents

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Bonus #2: Audiobook

Introduction

Chapter 1: Questioning ADHD

Chapter 2: Overcoming ADHD

Chapter 3: Paying Attention

Chapter 4: Stopping Procrastination

Chapter 5: Managing Your Emotions

Chapter 6: Loving Yourself

Chapter 7: Translating Goals Into Actions

Conclusion

Leaving a Review

Bibliography

About the Author

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Accepting yourself is a crucial step towards self-love and true happiness.
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perfectly fine to be yourself, with all of your amazing qualities and flaws,
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 Introduction

“You will do great today,” Marcus told himself as he made his way to the
building. Even if he wasn’t feeling that good, the power of positive thinking
would see him through. He approached the receptionist who looked bored.
“Good morning, how may I help you?” The girl said monotonously. Marcus
could tell he wasn’t welcome but he still persisted.
“I am here to see Mr. Clark for the interview. He told me there was a
position in his department and I was to come at around 9 AM,” Marcus
said.
“Well, Mr. Clark is not here yet. When he said 9 AM, it could mean
anything, from ten minutes, thirty minutes or even an hour past nine. He
usually arrives late, so you might be here for a while. You can just sit there
in the lounge, make yourself at home, and just wait until Mr. Clark arrives,”
she advised.
Marcus made his way to the gloomy lounge area. He was juggling whether
he should stay or he should go. Waiting here for an undefined number of
minutes was torture for him. Maybe, he should just reschedule. But that
could compromise his chances of getting the job. Maybe, he should stay for
ten minutes and see if Mr. Clark arrives. If he doesn’t, Marcus would need
to reconsider his position.
For the next ten minutes, Marcus kept pacing to and fro in the hallway. He
couldn’t sit still on the sofa and he felt so restless. He kept going to the
restroom every five minutes to wash his face. He kept looking at his
smartphone, browsing through his social media pages. Marcus kept thinking
about all the different questions which may be asked of him. Perhaps, Mr.
Clark will talk about his numerous job changes. Over the last five years,
Marcus had changed companies six times, always unable to settle down. He
just couldn’t figure out why he became bored so easily that he couldn’t hold
on to one job for more than a year. Or, Mr. Clark could ask about his past
performance. Marcus was worried because he didn’t exactly get good
ratings from his previous managers. He was told that he procrastinated a lot
and passed off work many days past the deadline. The only consolation
Marcus could think of was that he was highly creative and he had a good
portfolio to show Mr. Clark.
After ten minutes, Marcus checked the scene. Mr. Clark was nowhere in
sight. Marcus checked with the reception and was told that Mr. Clark wasn’t
in the building yet. He kept checking his clock and wondered if he should
go. Unable to contain his restlessness, Marcus resigned himself and walked
away. Maybe, this job isn’t for him.
“There must be some company around here where bosses come on time in
the morning,” he thought to himself.
After five minutes, Mr. Clark greeted the receptionist.
“Good morning Kate. Did you happen to see an applicant waiting for me? I
told him to come at 9 AM,” he said.
“Yes, Mr. Clark. But he just left five minutes ago. He said he had
somewhere to go to,” relayed the receptionist.
“Oh well. I was going to say he was hired for the position. But since he is
not here, I will have to get someone else. Thanks Kate,” said Mr. Clark.

Do you feel constantly restless? Do you have problems concentrating or

accomplishing tasks for a prolonged period of time? Do you constantly lose
things and find it hard to organize your schedule? Have your co-workers
and bosses complained about your procrastination? Have your family
members noticed that you often burst out in anger when you are trying to
resolve a conflict?
There might be days when you feel that you are going crazy. Therapists
may diagnose you with all sorts of mental illnesses including bipolar
disorder, obsessive-compulsive disorder or early-onset Alzheimer's. Friends
may often feel awkward around you, giving you labels like ‘weird,’
‘annoying,’ or ‘disorganized.’ Peculiar patterns of behavior often lead you
to underperform in your work, leading you to self-doubt and anxiety.
Personal relationships may become strained because you find your
emotions difficult to manage. You know that there is something wrong
about you, but you can’t just put an exact name that encapsulates these
patterns of behaviors.
Maybe you have Attention Deficit Hyperactivity Disorder or ADHD. You
may have heard about the term used to describe giddy children who can’t be
controlled by their parents. You may have come across the condition when
you watch celebrities proclaiming on television that they have ADHD. You
might have read something about ADHD in your social media pages or in
mental health forums as you try to self-diagnose. You wonder if you may
have ADHD.
This book will introduce you to the multi-faceted condition that is ADHD.
There are still a lot of things we need to learn and unlearn about this
condition. ADHD is not just a condition that afflicts children. It is also very
prevalent among adults and has been labeled as one of the most life-
debilitating conditions that could afflict people (Surman, 2013). ADHD can
affect your relationships with friends, family, and intimate partners. It can
compromise your productivity at work and restrain you from seizing career
opportunities. The condition may enable the development of other mental
illnesses like anxiety and depression. Although the global systematic review
of Song et al. (2021) projected that the prevalence of ADHD in adults is
around 6.76% translating to 366.33 million people around the world in
2020, these figures may most likely be underestimated. Many people still
experience the symptoms of ADHD but have not been formally diagnosed
or received any form of help for their condition. The misinformation about
ADHD has led to many adults struggling with understanding their
conditions and feeling isolated from everybody else.
It is good that there is a growing awareness about ADHD nowadays. There
are several researches currently underway to understand the complexity of
this condition. Many people are now more open to seeking professional
help. They are also more empowered to share their story with other people
and spread awareness for the condition. But the general trend in the
conversation on ADHD in adults has focused mainly on women having the
condition. A lot of self-help books, social media groups, and online
therapies are targeting women suffering from ADHD.
It is not true that more women have ADHD than men. In fact, Surman
(2013) conveyed that the difference between the prevalence of ADHD
among men and women is not significant. This means that ADHD can
occur in both sexes at a similar rate. But most of the resources on ADHD
cater to women and their stories of recovery.
This book is an attempt to empower men with ADHD to understand
themselves better. Men and mental health have a longstanding history of
disregard for each other. Social traditions have stereotyped men as being
strong, independent, and lacking in emotions. Any sort of sensitivity or
fragility in men is considered a weakness or even a feminizing character.
This irrational but prevalent mindset about men prevents a large population
of boys, sons, fathers, brothers, uncles, and grandfathers from
understanding themselves when they don’t fit in the ‘macho ideal’ of
society. Men are afraid to talk about being anxious or depressed for fear of
being considered weak in character. Because of this, the Center for Disease
Control and Prevention (2021) reported that in 2019, men are 3.7 times
more likely to commit suicide than women. The burden of mental illnesses
plagues men because of prevailing cultural standards for men.
You are not alone. There are a lot of men who may have ADHD and
struggle with it constantly. Some may be so repulsed by the idea of having
the condition even though they exhibit signs of ADHD precisely because
they don’t know anything about it. This book attempts to reach out to all
men who think they may have ADHD. It is important for us to know that
there are also other men who are experiencing the same problems and
challenges this condition has brought upon us. The more that you know
about the condition, the easier you can open your minds to being helped.
You do not need to suffer from ADHD alone. You are doing ourselves, your
family and your businesses a favor by choosing to embrace ADHD,
understand how it works, and build strong habits to mitigate its impact on
your lives.
Each chapter will touch on a different domain that is affected by ADHD.
We will go through a discussion on what the condition is and how you can
determine if you might have ADHD. A general approach to managing the
symptoms of ADHD will be laid out. The chapters are built around forming
five powerful habits for you to overcome ADHD. These will be very
helpful in dealing with daily problems you may encounter. These five habits
of combating ADHD in men include:
Paying Attention
Stopping Procrastination
Managing Emotions
Loving Yourself
Translating Goals into Actions

Work through each chapter slowly. The different stories in each chapter are
based on true stories of men living with ADHD. You might come to identify
yourself in some of these stories. You might even know of friends or family
members who may resonate with the characters and insights in each
chapter. Mull over each power habit and use them on a daily basis. Don’t
start on different habits simultaneously. Focus your mental resources on
developing one habit at a time. Share these insights with your family and
friends to help them be aware of your condition and progress. The more
help and understanding you can get, the easier you will be able to manage
the symptoms of ADHD. This book will help you appreciate having ADHD
even more. Instead of looking at how the condition can paralyze you,
perhaps you must look for new perspectives on how living with ADHD can
be a gift you have yet to unwrap.
Michael Phelps, perhaps the greatest swimmer of all time, with 28 Olympic
medals, had been diagnosed with ADHD when he was in sixth grade. His
mother, Debbie Phelps, always knew that having ADHD was not a
permanent hindrance for her son to achieve his dreams. Instead of letting
the detrimental effects of ADHD prevail, Michael and Debbie chose to
understand and surpass the condition. Debbie Phelps helped her son combat
the condition by supporting his many endeavors. She even said “The
diagnosis made me want to prove everyone wrong. I knew that, if I
collaborated with Michael, he could achieve anything he set his mind to.”
By choosing to overcome ADHD, Michael Phelps surpassed all Olympic
records in swimming. Like Michael, you can all surpass ADHD, one habit
at a time.

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 Chapter 1

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 Questioning ADHD

“Where did I place my watch?” Benjamin shouted in frustration. He was

running late and at 7 in the morning, he was still at home.
“Honey, check your pants in the laundry basket. You must have forgotten to
take them out last night,” yawned Fiona, his wife. She knew her husband
was quite careless with his things and this morning’s ruckus was a ritual in
the house.
“There, I found it!” Benjamin said triumphantly. “You’re a genius, honey,”
he beamed at his wife. Benjamin kissed his wife goodbye and headed
straight to the car. He had an important meeting at 9 AM but he still had a
lot of things to prepare. He was just a few blocks away from the house
when he yelled “I forgot my phone!” Grumpily, he drove back to the house.
“I think you left your phone on top of the table counter again,” Fiona said,
meeting her husband as he stormed back. “Better make sure you don’t
forget anything else before you leave,” she warned.
“Of course, I got my things in order. Thanks for this!” Benjamin exclaimed,
kissing his wife for the second time that morning. Fiona wasn’t too
convinced. Benjamin started the car, driving as fast as he could.
Benjamin knew he was really going to be late now. Downtown traffic was
already heavy at this hour, and he wondered whether he could make it in
time for his meeting. He honked in vain as the traffic inched slowly.
Anxious about the morning engagement, Benjamin began to run over the
things he needed to accomplish before the meeting.
“Presentation, check. Pointer, check. Laptop…oh no!” Benjamin exclaimed
yet again. He had totally forgotten his laptop at home. He made a
turnaround, punching the passenger seat in frustration. This would
definitely cost him another good half hour of traveling. It was a good thing
that Fiona was there again to the rescue.
As Benjamin arrived at the house, Fiona was already standing outside,
waiting for him. “I believe you're looking for this?” she said, holding out
the laptop bag. And I also placed your office reports in the bag, which you
also conveniently forgot. I don’t know how you are going to do without
me,” she signed.
“Thanks, honey. I’m just forty, but do you think I’m having Alzheimer’s or
something already?” Benjamin asked frankly.
“Maybe you’re just careless. Honey, you’d better shape up or you’ll be late
for your meeting. I won’t be there to help you at each step of the way,”
Fiona reminded him. As her husband sped off to the office, Fiona could
only shake her head. She had suspected that her husband had something
more sinister going on than Alzheimer’s, causing him to be careless about
his things. She just couldn't name exactly what it was.

When did you first suspect that you may have ADHD? Usually, people with
signs and symptoms of ADHD don’t realize that for themselves. Men who
have ADHD are first referred to clinicians by their family, friends, or co-
workers who may have noticed something strange about them. Certain
disruptive patterns of behavior like procrastination, forgetting things, or
emotional outbursts may have prompted people close to the person with
ADHD to recommend them to see a psychiatrist for professional help. The
very condition of ADHD makes the person with the condition oblivious to
it. What exactly is ADHD? How can we detect it in a person?

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What is ADHD?
The Diagnostic and Statistical Manual of Mental Disorders V (DSM-V), a
publication by the American Psychological Association (APA), classifies
ADHD under neurodevelopmental disorders. Primarily, ADHD is a
condition that affects around 5% of the global population of children and
adolescents (Polanczyk, 2007). Certain parts of the brain fail to form
maturely, leading to several characteristic patterns of behavior. Although
these symptoms may be detected as early as childhood, these can persist
into adulthood, creating debilitating impairments in an individual’s
personal, social and professional functional spheres. Friends, teachers, and
family members are the first people to notice symptoms of ADHD because
the individual may be oblivious to his actions. But the diagnosis is primarily
made by a clinician based on several tests and observations.
There are 18 core symptoms to diagnose ADHD, according to the DSM-V.
As the name suggests, ADHD presents with symptoms that fall into three
major categories: mostly hyperactive, mostly inattentive, and a combination
of both. A child is diagnosed with ADHD under the following conditions:
Inattention: Until the age of 16, the child exhibits six or more of the
following symptoms for at least six months of age that are not suitable or
developmentally appropriate for their age:
1. Makes careless mistakes in school, at home, or in any other setting
2. Has problems paying attention to tasks or play activities
3. Does not listen when spoken to directly
4. Does not follow instructions and does not finish chores or
schoolwork
5. Has problems organizing things and activities
 6. Dislikes having to concentrate on a task for a prolonged period of
time
7. Repeatedly loses things of importance

Hyperactivity: Until the age of 16, the child exhibits six or more of the
following symptoms for at least six months of age that are disruptive and
inappropriate for the developmental age:
1. Fidgets or squirms when seated for long periods of time
2. Leaves the seat frequently
3. Runs around and climbs even when not appropriate
4. Cannot play leisurely or quietly
5. Always on the go, as if ‘driven by a motor’
6. Talks excessively
7. Has problems waiting for their turn
8. Blurts out the answer even when not spoken to
9. Interrupts or intrudes on others in conversation

Combination: A mix of three or more symptoms from the inattention and

hyperactivity categories.
We take note here that these are the criteria to diagnose ADHD in children.
Notable differences are seen in adults. First, instead of six symptoms, only
five are required. Next, from the usual home and school environment,
characteristic behaviors are seen in the workplace and relationships in
adults. Adults also don’t exhibit hyperactivity by running through hallways
or getting out of their seats. Instead, the anxiety becomes more internalized.
Adults can feel hyperactivity as thoughts run in their minds even as they sit
in one place. But the DSM-V does not provide a separate category for
adults with ADHD and instead, appropriates the current guidelines for
children into the context of adults.
Observe also that the symptoms have to be present in an individual for at
least six months. This means that the behaviors are consistent and chronic,
not just occurring on some occasions. One or two episodes of forgetting
your keys are not diagnostic of ADHD. Maybe, you just really misplaced
your things or you were just tired at that moment. Acute hyperactivity can
be due to sugar-rush or genuine excitement over an idea or event. What we
are looking for when diagnosing ADHD is that there is significant
impairment in an individual’s activities over a prolonged period of time.
The behavior is observed over and over again, and six months is enough to
claim that the behavior is already chronic.
A clinician makes the diagnosis based on a number of tools including the
ADHD Symptoms and Role Impact Inventory (ASRI) or the Adult ADHD
Self-Report Scale (ASRS). The diagnosis is merely clinical since there are
no blood tests or imaging that are definitive for ADHD. Some
neuroimaging like CT scans or MRI can be used to support the diagnosis
but are not, in themselves, sensitive and specific for diagnosing ADHD.
Family, friends or even the individual himself may already observe
symptoms of ADHD, but a clinician’s diagnosis is still necessary.

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How Does ADHD Develop?
ADHD is a complex disease whose etiology may be from the combination
of genetics, neurobiological, and environmental risks factors. Like other
complex diseases like diabetes or hypertension, the development of ADHD
is multifactorial. Thus, there is a great need for more research on
investigating different factors and their interaction with the development of
ADHD. Our understanding of ADHD will continue to evolve as we
discover more associations between different factors.
Genetic Factors
Several gene segment modifications called copy number variants (CNVs)
are currently being investigated as having strong association with ADHD
(Harich et al., 2020). Molecular genetic studies show that ADHD is
polygenic, which means that several genes may be responsible for the
development of the condition (Thapar, 2008). Genome-wide association
studies (GWAS) implicate 12 independent genetic segments responsible for
ADHD. One of these includes FOXP2 which is also seen in severe speech
and language problems (Vernes, 2008). But singular mutations may not
necessarily result in ADHD because of the small effect sizes. This implies
that ADHD occurs only when several gene segments become mutated.
Adoption and twin studies show high co-expressivity of ADHD between
siblings and twins (Chang, 2013). Faraone and Larrson (2019) conducted a
systematic review of studies which showed a high 74% heritability of
ADHD. If there is a family history of ADHD, then we can also be more
watchful for symptoms of ADHD in an individual.
Neurobiological Factors
Several neurobiological factors also need to be considered when
investigating ADHD. Neuroimaging in diagnosed patients reveals several
underdeveloped areas in the brain most especially in the prefrontal cortex
and the anterior cingulate gyrus (Bush, 2010; Konrad & Eickhoff, 2010).
Basal ganglia and subcortical areas were also found out to be more altered
in patients with ADHD compared to those without the condition (Qui et al.,
2009). All of these correspond to a particular function, resulting in the
characteristic behavior of ADHD which we will elaborate on in the next
chapters. Suffice to say that underdevelopment in a brain structure will lead
to poor development of the functions that the structure controls.
Researchers like Volkow et al. (2011) elaborated a dopamine deficiency
theory to explain ADHD. Neuroimaging of adults with ADHD shows fewer
dopamine receptors and transporters compared to those without the
condition. Dopamine is one of the reward-system neurotransmitters of the
brain. This deficiency correlates with behaviors such as procrastination and
lack of task initiation. When there is less dopamine available in the brain,
there is a tendency to be less motivated to accomplish goals. Without
dopamine, individuals will not anticipate being rewarded, thus they will
have no motivation to finish things (Sapolsky, 2017).
Environmental Factors
Most of the evidence points to genetic and heritable factors that cause
ADHD. These are factors that we cannot totally control because they
organically occur. But several pieces of research claim evidence for
environmental risk factors that contribute to the development of ADHD.
These are factors that we can control and prevent in order to decrease the
occurrence of the condition.
There are a lot of studies that explore the interaction between the intake of
substances during pregnancy and the development of ADHD. Factors like
prenatal alcohol exposure (Bos-Veneman et al., 2010), smoking (Nomura et
al., 2010), antidepressants (Figueroa et al., 2010), and use of
antihypertensive (Pasker-de Jong et al., 2010). But these studies are
inconclusive and offer limited evidence to support a strong association with
ADHD. The only agent that was significantly linked to ADHD was lead.
Exposure to lead has consistently yielded a positive association with the
development of the condition (Cho et al., 2010; Nicolescu et al., 2010; Nigg
et al., 2006). This means that maternal or early childhood exposure to lead
may lead to the development of ADHD.
Maternal stress was also seen as a significant predictor of ADHD
development. Li et al.(2010) found out that children who were born to
mothers who suffered a trauma, such as a death in the family, had a 72%
increased risk of ADHD. Though the exact pathophysiology of the
association has not been elaborated, we can surmise that maternal stress
hormones in the perinatal period may have a deleterious effect on the child.
There are other factors like early traumatic events, prolonged exposure to
media or technology, and general psychosocial adversity that are currently
being investigated but have not been conclusive in having associations with
ADHD (Froehlich et al., 2011).
Genetic, neurobiological, or environmental factors may all predispose a
child to develop ADHD. The interaction of these factors is more
explanatory than a singular cause. We have to understand these different
etiologies because parents may end up feeling guilty for their child’s
condition. As much as environmental factors are to be faulted, the majority
of the causes of ADHD are still genetic. Understanding the complexity of
the condition helps us to focus more on managing symptoms rather than
blaming anything or anyone else.

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Common Misconceptions About ADHD
Here are some common myths about ADHD that we need to debunk. Part
of the problem with managing cases of ADHD comes from mistaken
perspectives of what the condition is and how it affects people. Some of
these are popularized in social media but not verified from research. We
need to be aware of these misconceptions and how they are debunked for us
to better care for people who might have ADHD.
It Only Exists in Children and Adolescents
Though ADHD is commonly diagnosed in childhood, it can persist into
adulthood. In the DSM-V, symptoms of ADHD must be present before the
age of 12. The full spectrum of the disease may not be apparent in a child,
but can still persist into full-blown ADHD into adulthood. There is not
enough evidence to support the theory of adult-onset ADHD (Ahmad et al.,
2019). Sibley et al. (2008) asserted that ADHD diagnosed in adulthood is
simply late identified ADHD. They followed children with ADHD-like
symptoms through young adulthood and discovered that these patterns of
behavior persisted into adulthood. ADHD-like symptoms and saw that these
patterns of behavior persisted through adulthood. More likely, adults with
ADHD are those who have been diagnosed with the condition early in
childhood or have not been identified earlier.
What does this imply? One, it means that we need to be more observant and
aggressive in managing children already diagnosed with ADHD. The
persistence into adulthood may mean that these children have not been
followed up enough or that therapy has been lacking. Most of these children
have been lost to follow-up. They may have gone for several treatments
during the first few years since the child was diagnosed. But somewhere
along the line, the consultations stopped. Parents may have thought that the
symptoms have become manageable, and hence discontinued subsequent
therapies. And without proper transitioning to adult medical care, these
individuals may exhibit more disruptive patterns of behavior as adults.
Also, there is a huge number of undiagnosed children struggling with
ADHD who will only seek help in their adulthood. Parents and teachers
may already see symptoms of ADHD but refused to refer the child to a
clinician for evaluation and management. The child could also exhibit
compensatory behavior that will offset the dysfunctions of ADHD. For
example, a child who is hyperactive and always speaks out of turn in class
may compensate for having brilliant grades. The behavioral problem is not
noticed since other factors seem to compensate for the misbehavior. In this
way, the child remains undiagnosed and no intervention is sought. These
children then develop into adults who can no longer compensate for some
aspects of their disability. Adult-onset ADHD is misleading because these
individuals already exhibited ADHD symptoms in their childhood but were
not attended to. The earlier we can detect ADHD, the more resources a
person may have in order to mitigate a full-blown adult ADHD.
ADHD Is A Learning Disability
ADHD is more of an execution problem rather than a learning problem.
First, teachers may begin noticing signs of ADHD in children who may be
performing poorly in class. But upon checking their IQ tests, their
intelligence is often in the normal range, or even above average. The
problem with these children is not so much that they can’t comprehend the
lessons, but that they have a problem in executing what they intend to do.
Having attention deficit means that these children often overlook small
details like instructions in a test which leads them to perform poorly in
evaluations. They get so giddy over boring details that they tend to leave
out important parts in a test. But when their attention is drawn to the
discrepancy, they can correct their work and do well.
This spills over to adulthood. Many of these men with ADHD have very
promising potential. They have high IQs and can be very creative. But
when it comes to performing specific tasks for their work, they do not
execute very well. They lack focus because they find repetitive work
boring. Work piles up on them until such time that they are not able to
deliver outputs. Their performance evaluation is low, not because they don’t
have the hard skills for the work but because they have poor work ethics.
Their potential is overshadowed by their weakness in executing tasks.
So it is not true that people with ADHD are illiterate or dumb. But people
judge them solely on their performance output. Men with ADHD imbibe
this inferiority complex and they begin to doubt themselves. They are afraid
to seize business opportunities because they know they will not be able to
execute tasks well as evidenced by their work history. These men think that
they won’t do well at work. And this results in them producing low quality
work. This vicious cycle of mindsets and outputs dooms men with ADHD
to continue underperforming. They can even be unemployed since their
bosses often don’t understand their condition.
Men with ADHD have normal intelligence, while some even possess an
above-average IQ. They can do well in school and at work, if only they can
be trained to develop their execution skills and control their hyperactivity
and poor attention. They are extremely creative and determined people, able
to accomplish goals if they can only focus their minds on them. They have
great potential to be productive in the workplace or their chosen careers if
only they can be helped to harness their gifts properly.
Only Boys Have ADHD
The ratio of the prevalence of ADHD between men and women is 2.28:1,
with an overall rate of 9.2% (Ramtekkar, 2010). This may seem that more
men have ADHD than women. But the true prevalence of ADHD in women
may not be fully known due to underdiagnosis. Men and boys tend to be
diagnosed more because they express the symptoms of ADHD more
prominently, commanding more attention. Classic symptoms of
hyperactivity like not being able to sit in one place, constantly running
around, or interrupting conversations are seen more in boys, prompting
parents to consult earlier and more frequently. Girls, on the other hand, may
tend to exhibit ADHD with more subtlety. Instead of being gregarious and
externally anxious, girls tend to be more restless mentally. They can sit in
one corner, looking pretty normal outwardly, but their thoughts are already
racing internally. While boys can be loud and aggressive in showing their
poor attention control, girls may exhibit this more quietly. They lose their
things constantly but they can compensate by locating these objects. Hence,
parents and teachers catch ADHD in girls less frequently than boys.
While ADHD can persist in both sexes, there seem to be more resources for
women on the management of the condition. Women are more vocal about
their condition and can express their inner thoughts and feelings more
publicly than men. This creates an illusion that there are more women who
have ADHD. But still, the true prevalence of ADHD is underdiagnosed
since adult men tend to shy away from seeking professional help even if
they are already exhibiting symptoms of ADHD. Poor health-seeking
behavior in men leads to more sinister and debilitating effects of ADHD.
Both sexes are in need of nuanced management, though the general
principles are the same. This book was precisely written to meet that gap in
men’s resources for ADHD. Through this advocacy, more men might be
helped in understanding their condition and develop good habits to manage
their symptoms.
ADHD Is Not A Serious Problem
Part of the reason why some teachers and parents don’t seek professional
help for overt symptoms of ADHD in children is that they think that
children will just outgrow these behaviors. They may already see
characteristic patterns such as speaking out of turn, poor attention to
instructions, or constantly tapping their feet. And yet, they don’t seek help
because they feel that these are normal habits children will outgrow. Some
teachers and parents may even claim that this is just sugar-rush, a sudden
gush of adrenaline common in children that don’t need further probing.
While it is true that children in their toddler and school ages can be quite
overactive, it is still worthwhile to seek professional help. Children may
overcompensate by doing well in school, but that doesn’t mean that they
have ADHD or that they will not exhibit symptoms when they are adults.
The point of seeking help is not to label and discriminate against children as
having the condition. Rather, therapists and clinicians can be added
resources in managing difficult children, whether or not they may have
ADHD.
ADHD in adults is largely overlooked as some people feel that the
diagnosis is just a fancy condition for celebrities or privileged people who
are hyperactive. People with ADHD often are labeled as ‘crazy,’ ‘stupid,’
‘disorganized,’ or even ‘explosive’ because they can’t accept that they may
have ADHD. The condition is not treated seriously because colleagues,
friends, and family think that the person with ADHD is just not trying hard
enough. Other people do not recognize ADHD as a debilitating condition
because they also feel that adults with ADHD are too lazy to try changing
themselves.
The reality is that ADHD presents as a spectrum of broad impairments. On
one end, you have highly functioning individuals who are able to work well
and develop positive relationships. On the other end, you have severely
dysfunctional individuals who are unable to be employed and fail at
developing close relationships beyond their immediate family. The range of
impairments is wide and people may exhibit varied problems and intensities
of the condition. But ADHD remains to be one of the most debilitating
conditions for adults. It can affect their family life, their ability to form
intimate relationships and friendships. Men with ADHD may underperform
in the workplace, leading them to be evaluated poorly or even rejected in
job opportunities. These men may develop co-morbid conditions like
anxiety and depression, leading to further impairment.
ADHD also poses a substantial financial burden to the individual.
Medications and therapies cost a lot, though some health insurance
companies cover this. The personal cost of managing ADHD can
overwhelm the individual who already has problems organizing himself.
There is also a societal cost to ADHD. When people with ADHD
procrastinate in their work or are disorganized with their schedules, these
small inconveniences can result in substantial deficits for the company due
to underproductivity. Businesses need to invest in helping their employees
overcome ADHD, not just for humanitarian purposes, but also to boost the
overall productivity of the business. ADHD has a lot of personal and
societal implications which need to be considered.
It is not true then that men will just ‘outgrow’ ADHD. It is not a
developmental phase that passes by without active management. Men with
ADHD are not lazy people or adults simply ‘not trying enough.’ In fact,
they are one of the most driven people. But without proper guidance, they
may not be able to achieve their fullest potential. They will always be
doubting themselves because of previous episodes of negative feedback.
The stigma of the condition prevents them from channeling their creative
genius into productive outputs. Men with ADHD need to be consoled that
they have a special condition that influences how they react to their
environment. By understanding that condition, they will be more able to be
conscious of their thoughts and feelings. With professional help and a lot of
social support, these men can overcome ADHD and realize their fullest
potential.

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What If It’s Not ADHD?
We also have to consider the remote possibility that the symptoms may not
be ADHD. As much as you may be experiencing hyperactivity or
inattention problems, it is plausible that other conditions aside from ADHD
may be at work. This should not deter you from seeking professional help.
In fact, you would need a clinician more to help you differentiate between
ADHD and other conditions. What we want to emphasize at this point is
that we have to be conscious of many other conditions before jumping to
ADHD conclusively. By broadening our awareness, we may be able to
moderate our expectations and be vigilant towards other clues that may help
us diagnose our condition.
Some disease conditions may mimic the cognitive problems with
inattention characteristic of ADHD. Infections that affect the brain such as
encephalitis or meningitis can cause acute mental disorientation or
inattention. A recent concussion or brain trauma from an accident or injury
may also produce acute symptoms of altered mental states. Endocrine
disorders such as thyroid excess or deficiency may lead to the inability to
concentrate or feel more jittery than usual. It is worthwhile to have a
comprehensive physical exam by a clinician in order to rule out some of
these conditions before diagnosing ADHD definitively.
Mental Disorders and ADHD
It may happen that other mental illnesses can mimic or even coexist with
ADHD. The symptoms of several mental disorders tend to overlap, causing
difficulties in diagnosing a patient. Torgersen et al. (2006) claimed that as
much as 80% of adults with ADHD experience another psychiatric
condition. The most common comorbidities include depression, anxiety,
substance use disorders, and personality disorders (Katzmann, 2017). The
burden of having ADHD and other psychiatric conditions makes the
individual more vulnerable and in need of more help. The following chart
shows how different psychiatric conditions overlap in terms of the
symptoms they exhibit:

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5567978/

The interaction of these psychiatric conditions actually reinforces each

other. It becomes a vicious cycle of one condition feeding the other. A
person’s attention dysfunction may lead them to lose their job which can
make them depressed. In turn, being depressed makes them inattentive
about details. The synergistic action of all these mental illnesses
necessitates professional intervention and a lot of social support. Through
therapy, individuals may become aware of these vicious cycles and find
ways to break the chain of mental illnesses.
Depression
As much as 30% to 60% of adults with ADHD are more likely to
experience a depressive episode compared to those without ADHD
(Fayyad, 2007). Some people with ADHD may feel a depressed mood,
diminished interest or pleasure in doing most activities, weight loss, lack of
or excess sleeping, and constant rumination of depressive thoughts. These
can occur during episodes for as long as two weeks, or could be chronic for
more than six months. A certain trigger could have started the initial
depressive episode. Divorce, unemployment, termination from work, or
rejection from an acquaintance may prod a person to entertain depressive
thoughts. Without mature coping mechanisms, an individual can easily be
sucked into a depressive mood. Men with ADHD are doubly vulnerable
because they lack awareness of regulating their emotions, making them
more susceptible to depressive symptoms.
Anxiety
The National Comorbidity Survey Replication (NCS-R) conducted research
on the coexistence of anxiety and other psychiatric conditions. The study
found that higher rates of comorbidities at 47.1% were found between
ADHD and anxiety disorders compared to 19.5% in the control group
(Kessler et al., 2006). This means that people with ADHD are more
predisposed to also have anxiety disorders. The most common conditions
include social phobia and agoraphobia. Anxiety is experienced as a fear of
speaking in public, avoiding situations where other people are present, or
being overwhelmed with minimal stressors. Men with ADHD have
problems when multiple tasks are given since they cannot focus on which
ones to start with. The inner feeling of restlessness and panic is shared by
people with ADHD and anxiety disorders. There is a difficulty to sit still
and wait in line as the tension and overthinking become too much for the
individual.
Substance Use Disorder
In the general population, the prevalence of substance use disorder is at
15%. In adults with ADHD, this can reach rates 2 to 3 times higher (Marks,
2001). Substance abuse can be in the form of smoking or nicotine, alcohol,
or illicit drugs. These substances can induce the release of reward hormones
in the brain, allowing a sense of pleasure to ease the restlessness of people
with ADHD. But as such, these substances are highly addictive and have
high abuse potential. ADHD itself confers an individual with poor impulse
control. Hence, people with ADHD are more prone to become addicted
given the nature of their condition. The dopamine deficiency theory also
complements this addictive potential. Because of low levels of dopamine in
the brain, individuals with ADHD get their reward fix from exogenous
substances like nicotine and alcohol. The natural neurotransmitters are
displaced by the substances ingested which artificially stimulate the release
of these happy hormones.
Through prolonged use of these substances, men with ADHD can suffer
from impaired cognitive functions and poor decision-making. Road
accidents and other physical injuries can be sustained when men with
ADHD are under the influence of these substances. It will be hard to resist
intake since withdrawal symptoms can occur. Tolerance may develop, and
men will crave higher and higher amounts of the substance to get their fix.
Again, a lot of interventions have to be made for these individuals. Men are
prone especially to substance use disorder as they externalize the anxiety
and tension they feel inside by taking these substances. ADHD exacerbates
this condition, while substance use disorder exacerbates ADHD in return.
Personality Disorders
In children who were diagnosed with ADHD, research showed an increased
risk of them developing personality disorders in adulthood. Miller et al.
(2008) listed the most common personality disorders associated with
ADHD including borderline (OR=13.16), antisocial (OR=3.03), avoidant
(OR=9.77), paranoid (OR=8.47), and narcissistic (OR=5.26) personality
disorders. The Odds Ratio (OR) indicates the ratio of individuals with
ADHD who will also develop the personality disorder. So adults with
ADHD are 13 times more likely to also have borderline personality than
those without ADHD, and so on. Personality disorders may not manifest
fully in childhood, but these behaviors may come out in adulthood. A lot of
these are relational in nature, dealing with how the individual relates to
friends, family, and intimate partners. Having an avoidant or antisocial
personality often makes men with ADHD less sociable and likely to
establish warm, mature relationships with non-family members. What we
may see as a personality disorder may actually be a manifestation of ADHD
that has not been diagnosed before.
Being aware of all these mental illnesses that can coexist with ADHD will
help us become vigilant in observing symptoms. It is not meant to anticipate
that these illnesses will happen to us. Rather, we need to watch out that our
condition makes us more likely to be depressed, anxious, or prone to
substance abuse. This should already prod us to seek help earlier than most
people. The more social support we can gather, the more we will be able to
manage our symptoms of ADHD before they can be complicated by other
mental illnesses.

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 Chapter 2

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 Overcoming ADHD

“Hi, my name’s Aiden, it’s very nice to meet you!” Aiden said confidently.
Going out on a blind date wasn’t exactly his thing, but Aiden’s sister
thought he should meet other women aside from their family.
“Thanks, my name’s Christie. I’m quite new at this, so bear with me,”
Christie said apologetically. Being thirty and single made Christie desperate
enough to go on a blind date. She found Aiden sweet and cute-looking, but
she wanted to reserve her judgment until the end of dinner.
“Me too,” Aiden confessed. “But I’ve been to several dates before. I dated
about three other women before this. One was a flight attendant and we hit
it off after I flew to Hawaii some years back. I got her number before
disembarking. But that didn’t last very long. And then, I met a colleague
from work, who was also an accountant like me. We hit it off well at first.
But after working on a common project, I felt that she was too bossy for me
and things got awkward for us in the office. My last date was with a painter.
She had her own studio which was really interesting because every corner
of the house was filled with different kinds of frames. She taught me how to
sketch. But after I broke one of her easels, she stopped talking to me. And
then, you’re the fourth!” Aiden said triumphantly.
“Oh,” was all Christie could say.
“Let’s sit down, shall we?” Aiden offered. “Let’s order something good. I
heard that they have delicious lobsters here. That reminds me of a time
where my family and I went on a vacation in Belize. We had this big lobster
platter for dinner. I tried to pry the shell open with a cracker. But I wasn’t
used to the gadget. So when I tried to press it, the lobster piece went flying
across the room! It was hilarious!” Aiden narrated, laughing at the
recollection.
“I see,” Christie remarked. “I guess we shouldn’t order lobster tonight,” she
said.
Christie could feel the awkwardness creeping in. “Maybe we can start
with…”
“Let’s start with a salad and some hors d’oeuvres. I think they have a
Spanakopita on the menu. It’s a Greek spinach pie that’s really tasty. I once
traveled to Greece for a study tour. We went through all the ruins and
museums in two weeks. I remember marveling at the Acropolis, still
standing magnificently. Greeks truly know that what is beautiful is what
lasts. I could almost feel as if the ancient Greeks were still walking beside
us during the tour!” Aiden said nostalgically.
“You seem well-traveled, huh?” Christie remarked flatly.
“Yes, I like to travel a lot. I like going to new places and meeting new
people. I’ve traveled to four continents already, and I want to go to Africa
soon. There’s something about that continent that always eludes me. Have
you ever been to Africa?” Aiden asked.
“No, but I’ve seen in videos that it looks very inviting. I think the pyramids
are…”
“Egypt! Yes, I’ve heard a lot about that place, and I also want to go there.
After watching ‘The Mummy’ series, I just want to hop on a plane and see
the pyramids for myself. I’m just worried that the security situation there is
not yet conducive to travelers. I don’t like crowds myself, and I don’t know
if I can stand the heat. I’ll have to muster enough courage to try visiting
Egypt,” Aiden declared.
Christie could only nod in agreement.
“This is fun. I think we have a lot in common. We like to travel and try
different experiences. You must have your own travel stories too. I’m really
glad we’re doing this date!” Aiden remarked.
“I’m sure you do!” Christie said sarcastically. She could barely wait for the
dinner date to end. It was her first time to encounter a man who dominated
the talking, going on endless stories and never allowing her to share hers.
She just hoped it was her last to meet such a man.

As a debilitating condition, ADHD can be rather daunting to confront. The

repeated negative feedback from work, the misunderstandings from family
and friends, and our personal self-doubt may paralyze us into helplessness.
The creative energy we feel inside does not translate into the outputs and
goals we imagine, frustrating us on so many levels. But rather than being
overpowered by this negative mindset, we have to inculcate in ourselves
that ADHD is surmountable. Say it again, louder this time: “ADHD is
surmountable!” By knowing where and how to get help, we can be more in
control of ourselves and achieve the goals we set.
How do we manage the symptoms of ADHD? The first step is to realize
that we have a problem. As the previous chapter says, men with ADHD are
often the last to know that they have the condition. Co-workers, family, and
friends are often the first people to become aware of the condition because
they are at the receiving end of the dysfunction. And when they confront us,
we are sometimes defensive about our behavior. It is quite humbling to be
told that we may have attention deficits or that we are craving too much
attention. Men don’t like to be told that they have these character problems
and that can get in the way of accepting our condition.
Entertaining the possibility that you may have ADHD is the first step to
acceptance. Perhaps you have ADHD, perhaps you don’t. Given the
feedback from other people, you should be open to the idea that you may be
suffering from an organic cause that can be treated. Either way, it will be
beneficial for you and the people around you if you seek professional help
and get yourself diagnosed. You have everything to gain by seeking help,
and everything to lose if you keep on denying it. If it turns out that you
don’t have ADHD, then well. There might be other causes for your
dysfunction. But if it is ADHD, then you are in a better position to
understand your condition and get the help that you need.
Once you get a diagnosis of ADHD from a clinician, several management
options can be available for you, depending on your symptoms. Treatment
is symptom-based and may differ from person to person. Others may need
to be dependent on medication, while some would benefit more from
therapy. Be aware that there are a lot of resources available to you should
you need help. In this chapter, we will discuss the different modalities of
treatments available for men with ADHD. We will also be advocating for a
pro-active framework in approaching this condition.

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Pharmacotherapy
Pharmacotherapy remains the cornerstone of treatment for ADHD
symptoms. As a caveat, I must confess that I am not a medical doctor. You
will still need to seek the help of a medical professional in order to take
these medications. Any adverse side effects of these drugs must be properly
explained to you before you start any regimen.
ADHD is a complex disease affecting different life domains, medication is
geared towards the specific symptom of concern. The American Academy
of Child and Adolescent Psychiatry Practice Parameter for ADHD says that
the combination of therapies and medication is the most efficacious
treatment for ADHD (Plizka et al., 2007). This also applies to adults in
controlling specific behaviors.
Medications for ADHD are targeted and not broad. When considering the
medication of choice for you, the doctor will ask what your treatment goals
are. There is no such thing as a wonder drug that will cure all the symptoms
of ADHD. When you have a goal as general as ‘I want to get better from
ADHD,’ you will really struggle in meeting broad expectations. The goal is
not specific enough and no medication can cure such a broad target. Good
targets are specific and symptom-based. You may say to your doctor that
you want to stop fidgeting as much or you want to be able to increase your
concentration at work. You can even be more specific than these, such as
wanting to complete your morning paper works for a week. By making
goals this specific, the doctor can prescribe more appropriate medications
that can address the specific symptom.
Generally, improving attention dysfunctions rely on the use of stimulants
containing methylphenidate or amphetamine. Medications with these
components increase the level of dopamine in the brain, activating the
striatal and cortical regions that control attention (Markowitz et al., 2008).
Treatment is usually long, which means you have to take the drug for some
months and weeks to get a noticeable effect. It does not work when you just
take this medication when you are symptomatic or whenever you just feel
like it. Compliance with medication helps the brain regulate the necessary
neurotransmitters that will facilitate better attention and control of impulses.
As we have emphasized, these drugs are targeted to a specific behavior.
These medications may not work in situations where higher-level cognition
is dysfunctional. For example, Methylphenidate Hydrochloride (MPH) may
be effective in helping a person concentrate on a particular task. But higher-
order functions like organizing ideas or regulating emotions may be too
complex for any one medication to address. Hence, there is benefit in
combining medications with psychotherapy.
Comorbidities also have to be managed. If you are experiencing symptoms
of anxiety, then an anxiolytic medication such as Fluoxetine, Paroxetine, or
Escitalopram may work best for you. If there are depressive episodes,
antidepressants like Bupropion, Desipramine, or other selective serotonin
reuptake inhibitors may work better for you. Each new symptom has a
different pathophysiology necessitating different medications. While we do
not recommend medications all of the time, we should also recognize that
there are cases when medications are necessary. However much you want to
will yourself to get better, the lack of certain hormones or neurotransmitters
will not respond to sheer willpower.
Good communication with your clinician is key to making drugs work for
you. Each pharmacological plan is individualized to a person. There are
people who may need medication for years and there are those who may
only need it for several weeks. Some patients complain of tolerance to the
drug, wherein the usual dose does not exhibit the same potency as before.
There might be a need to change the drug or increase the dose. Consider
also that you can be weaned off from the drugs completely if your
symptoms have improved.

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Cognitive-Behavior Therapies
Skills-based therapies to target particular behaviors are the mainstay for the
treatment of ADHD. While medication will address the biochemical
alterations caused by the disease, this is not enough to address higher-order
cognitive dysfunctions. Among the therapies available, cognitive-behavior
therapies (CBTs) are considered one of the most effective treatments for
ADHD. In a clinical trial by Solanto et al. (2010), there was a greater
reduction of ADHD symptoms in patients who underwent CBT than those
who didn’t. Most of these therapies require a month to year-long treatments,
where the patient has to establish a good alliance with the therapist to
maximize the effect of the therapy.
Like medications, CBT is also targeted. The patient is the one who is in
control of which behavior should be improved. The therapist asks the
patient what goals he would want to achieve at the end of the therapy. As
such, specific skills are developed in a person. For example, a patient may
identify procrastination as an issue they would like to resolve. The therapy
would then revolve around interventions that will help the patient to
increase their skills in organization and planning. By naming the goals of
therapies, men with ADHD can own the therapeutic process. They are
empowered to obtain skills relevant to their work or relationships.
As the name implies, CBT works by making the patient more conscious of
his cognition and the corresponding behaviors. Men with ADHD are made
to be aware of how their behaviors result from a particular kind of thinking.
If the behavior is losing the cell phone constantly, the therapist asks what
the patient must be thinking that led to that behavior. Perhaps the problem is
not paying close attention to small details or there is a problem retaining
memory for trivial objects. The therapist draws the attention of the patient
to his particular cognitive process. The goal is for the person to realize that
his thoughts affect his behaviors. By changing the thinking process, the
person will be more able to change his behavior.
There is value to undergoing therapies because having another person
mirror your behavior adds a certain objectivity to the treatment. There
might be instances where you are not aware of your own tendencies. We all
have blind spots, aspects of ourselves that we may not be cognizant of. For
example, we may not be aware that our emotional outbursts are already
excessive to other people. By talking to a professional, the patient becomes
more aware of this gap in self-identity. The therapist simply helps the
person understand himself more objectively by mirroring his thoughts and
behaviors.

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Think-Feel-Do Framework
In this book, we are advocating the use of the Think-Feel-Do Framework. It
is a takeoff from the CBT model that aspires to connect cognition to
behavior. But a major addition of this approach is the emphasis on emotions
and feelings. We should recognize that feelings play a major role in
affecting our behavior and thoughts. Leaving it out of the equation makes
men with ADHD more vulnerable to impulsive swings and emotional
outbursts. We will see how the framework can be applied in different
aspects of a man’s life in the succeeding chapters.
Think
We will be discussing different mindsets and thought patterns common to
men with ADHD. Each chapter will focus on a particular area of the brain
and the corresponding dysfunction that may occur if you have ADHD. As
we have emphasized in the previous chapter, ADHD is not a learning
disability. Most people with ADHD have normal intelligence, while others
even have above-average levels. The problem is centered mostly on the
executive function of the brain.
The most comprehensive explanation for the different behavioral patterns of
ADHD can be due to executive function disorders. An executive function
(EF) is the ability of a person to persist in goal-directed plans (Barkley,
2012). It is an overarching function that governs other skills necessary to
achieve a goal. You can just imagine that the EF is like an executive or a
manager orchestrating the different movements in a company. These
subfunctions consist of higher-order cognitive activities like problem-
solving, planning, regulation of emotions, and management of information.
These functions should aid the person to achieve a targeted goal. Men with
ADHD have poorly-developed EFs in one or more domains. Each chapter
will focus on a particular EF that can be addressed.
Feel
One of the core dysfunctions men with ADHD exhibit is emotional
dysregulation. The DSM-V does not include emotional lability as a criterion
for diagnosing ADHD. But based on observations in clinical practice,
emotional dysregulation often accompanies the symptoms of hyperactivity
and inattention (Adler et al., 2017). Men already struggle with emotions in
general, but the burden of handling such feelings is doubly difficult for
those with ADHD.
First, men have difficulty with emotions because of the prevalent social
stereotypes. The ideal man is one who is ‘macho, independent and
aggressive,’ with no room for sensitivity or being too emotional. The adage
‘Boys don’t cry’ reinforces the idea that men should not express emotions
outwardly and too blatantly. When faced with a particular conflict, men
respond by going into a problem-solving mode. Instead of focusing on the
pain and other negative feelings, men choose to focus on finding the
solution to the problem. While this may address the conflict, this mode
completely ignores the value of emotions.
Emotions are our fleeting reactions to a situation. We can be sad, glad, mad,
or angry in response to a certain context. Feelings are powerful enough to
influence our behavior. If we are happy, we hug a person. If we are mad, we
can be capable of hitting the aggressor. In men with ADHD, these emotions
are not regulated. The intensity can be too overwhelming to handle. As a
result, impulsive behavior is seen. There is no room for thinking about
rational decisions as reflex behavior takes over. When somebody punches
them, the impulsive person punches back, even if the context is not
appropriate for it. This may lead to decisions that are poorly thought of and
may be cause for regret.
A running thread through the chapters is a constant reference to one’s
feelings. By constantly identifying and being aware of our feelings about a
situation, men with ADHD can be helped in terms of regulating their
emotions. Feelings are very important drivers of behavior. But they can
only be useful if mediated by our thinking. We will develop strategies on
how to manage emotions to achieve our goals.
Do
The end goal of all therapy is of course to produce a particular kind of
desired behavior. At the beginning of the therapy, the person must decide on
a particular behavior he wants to improve or correct. The desired behavior
must be relevant to a person’s lifestyle. There are so many behaviors that
can be targeted. It can include passing work before deadlines, waiting
patiently in line, not interrupting conversations, or learning how to organize
your workspace. Skills take time to be acquired so the person must really
commit to developing one skill at a time. Consideration of skills must take
into account what a person really needs in the short term or which ones he
can commit to more realistically.
Each chapter will focus on one particular habit that can be developed by
men with ADHD. The goal here is not just to acquire habits that can easily
be eroded. You can learn one skill and forget it after some time or when you
are not actively using it. Skills tend to become rusty or dated when people
don’t use them on an everyday basis. Hence, we should not target acquiring
irrelevant skills and those which are only used occasionally. The goal is to
form good habits.
Habits have been defined as behaviors that are enacted automatically in
response to a particular context (Neal et al., 2012). They are enduring
patterns of behavior that are formed as a reaction to a situation. For
example, you wash your hands before eating a meal or you brush your teeth
before going to bed. The behavior is done reflexively because the situation
happens habitually. Over time, the action persists even without conscious
thinking. The more the action is repeated, the more reinforced it becomes. It
will be hard to shake off these habits because repetitive behaviors change
the brain structurally.
In managing ADHD, we will need to both unlearn old habits and form new
habits of behavior. Inattention and hyperactivity are the programmed
response of men with ADHD, constituting actions which they do repeatedly
without conscious thinking. In this book, we will walk through several bad
habits that have been formed as a result of the condition. By becoming
aware of how these bad habits create dysfunctional behavior, men with
ADHD will be able to be more conscious of their actions. We will also
discuss several good habits that may replace those dysfunctional patterns of
behavior.
Any change in behavior will be met with fierce resistance. If you have tried
to quit smoking, you know how hard the ordeal is. In the same way, any
new patterns of behavior will require a lot of effort and patience from you.
The book is not designed to be read from cover to cover. To assist you
throughout this book, you may choose which sections you would want to
work on. If you feel that improving your personal relationships is your
current priority, you can skip to that chapter. If you feel burdened by your
lack of concentration in your studies, you can read back on that particular
chapter. Use the book according to your needs.
Don’t rush on finishing each chapter. The goal is to do the exercises and not
just read about them. Gardner et al. (2012) said that it takes around 10
weeks to form a new habit. Try practicing each exercise for this amount of
time to reinforce the habit you want to achieve. You can dwell on a
particular chapter for the same amount of time, using every opportunity to
practice the skills highlighted in each chapter. Develop the power habit
emphasized in each chapter. Repeat, repeat, and repeat until you’ve formed
the habit. You don’t need to acquire all five power habits in one sitting. Just
one habit, done well and with commitment, will be enough for any given
time. You can proceed to developing the other habits only if you have
mastered the previous. The road to achieving your goals and forming life-
giving relationships is not impossible for people with ADHD. You are
gifted more than you can imagine. You only have to trust yourself that you
can acquire all these habits and reach your fullest potential. Think. Feel.
Do.

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 Chapter 3

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 Paying Attention

“Noah, can you come here for a second?” Mrs. Harris asked. The esteemed
English teacher led Noah to a quaint-looking office.
“What’s up, Mrs. Harris? Did I do anything wrong?” Noah asked nervously.
He was used to these kinds of invitations. He wondered what he could have
done this time.
“I’m just concerned about your performance in my class. It just pains me,
my dear, that you have one of the highest IQs in my class but you are not
living up to your potential. Your English aptitude test is one of the highest
I’ve ever seen. At the start of the semester, I had high hopes for you. But
each essay and summative test you submitted, you consistently got low
grades. Can you explain to me any of these?” Mrs. Harris said wearily.
“I guess I’m just not good enough. I really like your class, Mrs. Harris. But
I’m just no good in writing,” Noah explained.
“I don’t agree with that. You are a brilliant writer, Noah. It’s just that you
stumble over minor details. You always have a knack for misreading
instructions. For example, in one assignment, I asked you to write about
“How Cryptocurrency Works”. Instead, you wrote a brilliant essay on “How
Kryptonite Works”. Do you remember that?” Mrs. Harris asked.
“Yes. I must have missed that last part. Maybe, I was so intent to finish it
that I didn’t read the instructions well enough,” confessed Noah.
“Yes, it’s frustrating for you and doubly frustrating for me. This sort of
carelessness is seen in your other works. You forget a certain detail, you
miss out on an assignment and you constantly pass late papers. However
brilliant your writing may be, these small details hurt your grades
substantially. And it pains me to see you not maximizing your true
potential,” Mrs. Harris lamented.
“I don’t know. I just feel very restless when sitting down to write anything.
The writing process is so tedious, I just want to get it over with,” explained
Noah.
“You are very smart, Noah. I don’t doubt that you are a brilliant student.
But if you keep going at this, then that brilliance of yours is for naught. It’s
such a waste of good talent,” Mrs. Harris exclaimed.

Do you miss out on important details constantly? Do you forget to read the
instructions? Have you gotten low scores because of carelessness? It is very
frustrating to miss out on goals just because of a few crucial mistakes. We
may dismiss some minor details because we feel that they don’t matter
substantially. But in school as well as in the workplace, these ‘minor’
details aren’t minor at all. If we don't pay attention to these concerns, they
can have a significant impact on our performance in school or at work in
the long term.

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Common Problems Encountered
How do men with ADHD experience inattention dysfunction? There are
many scenarios where carelessness or lack of attention is experienced,
resulting in a wide range of outcomes, from non-events to disastrous after-
effects. As a child, you may have encountered some of these scenarios. But
as adults, inattention continues to become a problem in several functional
domains of life. Here are some scenarios where you might typically
experience inattention dysfunction:
Missing Out on ‘Minor’ Details
In most workplaces, attention to detail and instructions is crucial. If you are
in the fashion industry for example, every single button, shade or hue, type
of textile, or pattern matters a lot. If you are working in technical jobs like
manufacturing or mechano-chemical industries, one single minor mistake
may result in safety issues at work and with your customers. What we think
of as ‘not important’ are actually important in any industry we find
ourselves in. If before, we can get away with not coloring a particular
corner of a drawing or misspelling some words, it is not the same in adults.
Noah’s mistakes in the anecdote are forgivable and even cute for children.
But when these behaviors are carried over to adulthood, they pose a
significant threat to properties and lives. If you are a doctor with ADHD
and you don’t pay attention to a patient in the emergency room, your
careless mistakes can mean the death of the person. Much is at stake when
we don’t pay attention to ‘minor’ details.
Gaps In Understanding
You can be reading a particular document for hours on end and still not be
able to understand anything. Your eyes could be going over the same
paragraph again and again but not retaining anything. This can be a
nightmare for editors, lawyers, or any profession where a lot of reading is
required. Your mind can be distracted by a passing blue car when you
should be focusing on a particular paragraph. Attention precedes any other
higher cognitive function. The lack of attention translates then to poor or
even non-understanding of a material. Reading purposelessly can eat up a
lot of hours, resulting in unproductive time. Even if you can learn quickly,
your understanding of materials that are not interesting to you is limited
precisely because you don’t pay attention.
Losing Things Repeatedly
Have you ever spent hours looking for your keys or wallet and finding them
in your usual place? Do you constantly lose pens or small items? We all
lose or misplace our things once in a while, and it can be frustrating. But
men with ADHD lose these things far more frequently than others. They
don’t lose big items like laptops or speakers. What gets lost in the mess of
the desk or room are small ones like keys, phones, wallets, TV remotes, or
earphones. It can take up so much time just to find a pair of socks or
favorite tie.
Men with ADHD dismiss this symptom because they are able to
compensate for it. They don’t seek help because somehow, you are able to
find your missing keys after a long search. Losing things is not considered a
problem because it gets resolved by anyone. This misses out on the
important diagnosis of ADHD. It is not so much as the losing and finding of
things that is problematic. The issue is the inattention that causes the
constant loss. There is significant strain on an individual when he cannot
find his things easily.
There are other occasions where inattention dysfunction is apparent. The
consequences are profound because it can take so much time and effort just
to redo careless mistakes. When men with ADHD are not aware that they
have an attention problem, there is a tendency to keep on dismissing minor
details and achieving the same failed results. Poor attention can affect and
compromise relationships in the long run.

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Think
What goes on in the mind of men with ADHD when they fail to be
attentive? An understanding of how attention works in the brain may be
necessary at this point. Attention is a high order cognitive function. Our
brain processes so much data from the environment through our senses.
What we see, hear, smell, touch and taste goes directly to the brain for
processing. Inside the brain, the prefrontal cortex is in charge of accepting
all these inputs from the senses and makes sense of it. All the senses are
integrated in such a way as to organize stimuli into a cohesive whole. When
a dog stands in front of us, we can see and hear it. When we touch the dog,
the texture is imprinted in our brain. When we sniff it, the smell is
coordinated with our overall experience of the dog. The prefrontal cortex
pieces together all these different information to make a unified experience
of the stimuli.
Attention comes in as the brain’s way of giving importance to certain
information over others. The discriminative nature of attention is necessary
because we only have a limited mental space. We all practice some form of
selective attention. When you are in a lecture, sometimes, you can’t pay
attention to everything the teacher says and you just focus on the more
significant or memorable ones. When you are shopping for clothes, you
don’t go through rack per rack, item per item in the clothing stores. You just
focus on pieces that draw your immediate attention. Selective attention
saves us time and effort from sifting between important and less important
information.
The problem with this cognitive shortcut is that we may tend to miss out on
important details. By focusing only on particular details, we can make
erroneous decisions or costly mistakes. Driving home from work, you can
be so tired that you miss a turn on the freeway. Instead of using gluten-free
dough, you used the usual dough for your pastries and this can harm the
customers in your bakery. Small, careless mistakes like these may cause
significant repercussions.
This problem can be magnified in men with ADHD. The carelessness is not
seen in singular events or random episodes. The pattern of inattention is
consistent in several domains. Your dad can forget his keys going to work,
can’t concentrate on watching the television, or misread food labels. The
dysfunction can severely impair their ability to come to report for work on
time while looking for lost objects. Inattention can have life-threatening
implications for men with ADHD in some situations.
The inattention can also come from a passive disregard for small, boring
stimuli. Men with ADHD can pay attention to the more exciting, salient
parts of an experience, rather than the monotonous or repetitive ones. If you
give them a document, they will probably read the first and last paragraphs,
retaining some details which stand out in the middle. But the rest of the
‘boring’ stuff is skipped. And these ‘boring’ parts may actually be the most
important and relevant in the whole document.
When coming up with strategies to change the way men with ADHD think,
we have to understand why they do what they do. Why do they forget these
small details? Do they find it boring to read a bunch of paragraphs with
unexciting, technical jargon? Are they rushing to complete another task?
Does the topic not interest them at all? Responses to these will guide you to
understand the mindset behind the behaviors.

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Feel
As we’ve emphasized in the previous chapter, feelings are important to
consider since they also influence behavior. Emotions can actually affect
what information we retain or forget. Phelps et al. (2006) conveyed that
emotion-laden stimuli are given priority in relation to survival. We tend to
be more attentive to details that can be potential sources of threats. On the
other hand, we may be less attentive to stimuli that are not immediately
urgent or dangerous to us. Our subjective experience may impact what
details we pay attention to. For example, if we are in a happy mood, we
tend to remember only the positive and bright experiences. If we feel
depressed, we tend to notice only the negative and gloomy aspects of
things. Our emotional state affects what the brain chooses to focus on.
We can ask what your emotional state was when you were trying to
accomplish a particular task that required a lot of attention. Were you
anxious or angry? Were you calm and collected? What were your dominant
feelings as you went through the exams? What were you feeling when you
were looking for your lost key? What emotions were going through you as
you read a particular text?
Sometimes, anxiety may cause men with ADHD to gloss over tiny details
that matter. Imagine that you are late for work and you’ve lost your car
keys. You feel anxious, frustrated, and angry about the situation. All of
these feelings can be overwhelming and may cloud your ability to think
clearly about where you placed your keys. You may know exactly where it
is, but the anxiety makes you forget such minor details. The same is true for
other cases of attention. Overwhelmingly negative emotions like anxiety
and depression may inhibit our ability to concentrate on specific tasks.
Knowing how these emotions affect attention may allow men with ADHD
to be more aware of such emotional states.

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Do
Increasing our awareness of how our thoughts and emotions can affect
attention, we can now target behaviors which will increase attention. The
habit of paying attention can be developed by practicing simple exercises
that will increase your focus on your tasks. Having ADHD does not mean it
is not possible to control your attention span. By repeatedly practicing self-
awareness and attention to detail for 10 weeks or more, you can develop
good habits that will make you concentrate better.
Slow Down
Some of the hyperactive symptoms can actually exacerbate inattention
dysfunction. You may be in a rush to accomplish a task that you overlook
small, important details. The key here is to slow down. This may seem
impossible to a person with ADHD. It is like saying ‘stop being depressed’
to a person who is depressed. It is a tall order which goes against the very
nature of the condition. But there are a number of strategies which you can
try in order to slow down and pay more attention to details.
For instance, when reading any text, break the document down into smaller,
manageable pieces and check your understanding. If you cannot concentrate
on reading whole paragraphs, finish one sentence first. Pause before
moving on to the next sentence. Did you understand the sentence? Proceed
only if you can understand the basic message of each word and phrase. If
even a sentence is cumbersome for you, then try absorbing it word per
word. Don’t mind if there is a time limit. The purpose of this exercise is for
you to really absorb details as slowly and completely as possible.
Double Check Everything
Make it a habit to double-check everything before you pass projects for
evaluation. Sometimes, we can be overconfident that we have checked all
items according to instructions. If your history already shows how you
perform badly over simple careless mistakes, it's definitely time to improve
your process. Instead of assuming that you have done everything perfectly,
assume that there is something more that can be improved. Whether that is
a test for school or a presentation for work, make it a habit to run over the
material twice, thrice, or even more until you are satisfied. It is in the tiny
details that we become careless, so we have to make an extra effort to cover
these small details.
If you don’t feel confident, have your work checked by a peer before
passing anything. We all have our blind spots and another perspective may
help us identify errors in our understanding and execution. This may not be
possible for examinations or other self-evaluations. But for tasks that are
team-oriented, it might be helpful to solicit the help of other people. Ask for
feedback on your work. Note which mistakes keep on appearing again and
again. On the next project, focus on this feedback so that you don’t keep on
making the same mistakes.
Removing Distractions
Failing to focus on tasks may be due to a lot of distractions that surround
us. Our brains have a limited capacity to focus and distraction takes up
those precious mental spaces that should be reserved for attending to your
tasks. Removing distractions will increase your ability to concentrate. We
should be aware of both external and internal distractions.
External distractions are physical objects, persons, or events that can divert
our attention away from our tasks. The goal here is to remove these
distractions completely away from us. If you are going to read a report,
choose a spot where you can be quiet and alone. Don’t choose a place
where you will meet friends or acquaintances. You cannot resist the urge to
chat or just notice passersby. Eliminate these physical distractions so that
you can focus on the work.
An emerging major distraction is technology. We cannot resist the urge to
check our phones every other minute. Men with ADHD often feel that
something is missing or wrong if they are not able to check their social
media accounts every now and then. The constant visual and auditory
stimulation of gadgets somehow eases the anxiety they feel inside.
Clements (2021) emphasized the role of dopamine in this anxiety reduction.
She said that dopamine, as the ‘reward neurotransmitter’ of the body, is
released when we do something pleasurable, such as when we use our
cellphones. We crave more of that pleasure, hence we become addicted to
using our smartphones. In men with ADHD, dopamine levels are low.
Hence, using smartphones can compensate for that deficiency. Men with
ADHD are more prone to be addicted to using smartphones.
Too much consumption of media or technology can make you extremely
distracted. In order to address this, find creative solutions where you can
disengage from your gadgets. If it is possible, place your phones away from
your immediate workplace. If this is not possible, set time limits to your
gadget use. For example, you can only open your mobile phone after an
hour of work or after completing a particular document. These measures
will enable you to control gadget use and maximize your time for
concentrating on more pressing matters.
Rephrasing and Engaging the Senses
When you have problems paying attention to a given document, a trick you
can use is to engage as many senses as possible. Being hyperactive, the
ADHD brain thrives on stimulation from different senses. Perhaps, you can
exploit this tendency by approaching ‘boring’ materials through creative
ways. For example, you might be studying for a physics exam and you just
can’t understand your textbook. Try watching videos that explain the same
concept through creative visual presentations. Listen to podcasts on
teachers or scientists discussing the same lesson. If it is possible, apply
physics concepts in real life. If the topic is on gravity, you can conduct
different experiments showcasing how different objects fall at a particular
rate. The more senses you recruit, the more information will be available
for the brain to process.
This is what makes men with ADHD creative. They know they have a
problem with attention. But it does not stop them from understanding
concepts and accomplishing tasks. By using different senses for your
learning, you sustain your attention in different modalities. Learning is
reinforced, while the natural hyperactivity of the brain is utilized well. If
you cannot control the symptoms of ADHD, you can use it to your
advantage.

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 Chapter 4

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 Stopping Procrastination

“Oliver, where is the Korkunov report? It was given two weeks ago and I
haven’t received any update. Can I expect to see the report this afternoon?”
Mr. Johnson demanded.
“Yes, boss. I will just try to find the file,” Oliver replied hastily.
He knew he started that report, but he wondered if he ever got around to
finishing it. Perhaps, he can just wing the rest of it during the afternoon.
“Oliver, did you make copies of the Trudeau report? Mr. Jenkins needs it in
fifteen minutes,” Sarah, the secretary from downstairs said.
“I’ll send it in a minute,” Oliver brushed off. Sarah had given him the task
the day before, but he just couldn’t get around to doing it. Oliver kept
putting it off, thinking that he could easily print copies whenever requested.
But now, he was panicking because he didn’t know where exactly the
Trudeau report was.
“Oliver, we’ll be expecting your presentation in an hour. I’m sure you’ll do
great!” Mr. Lambert beamed.
“Sure!” Oliver muttered. Of course, the presentation was today! He had
totally forgotten it. He was supposed to start it last weekend, but he never
got past the first few slides. Oliver knew he was in deep trouble.
Oliver knew he wasn’t doing well in his job. Work seemed to pile up
everyday and he didn’t know where to start. His bosses praise him for his
creative talent, but somehow, Oliver often missed the mark. He couldn’t
control himself from procrastinating, however much he wanted to change.
Oliver mulled on changing jobs for the nth time this year.
Do you constantly feel like putting off work for another day? Does your
workspace feel crowded that makes you feel overwhelmed with the work?
Do you detest boring, clerical tasks? There are definitely low moments in
our work, but men with ADHD face the challenge of the workplace with
added difficulties.

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Common Problems Encountered
Men with ADHD often feel a lot of tension in the workplace. There is a lot
of tension and challenges in the office, exerting a lot of stress on everyone,
but most especially those with ADHD. Men with the condition struggle
with completing tasks or meeting deadlines. Bosses often give them poor
performance evaluations, not because they cannot do the work, but because
they don’t complete tasks on time and with consistent quality. In this
chapter, we will be examining a common complaint of procrastination
among men with ADHD.
Putting Off Work
We all have our lazy moments at work, days when we don’t feel like being
productive. It may be because the work is not interesting for us or that we
are not passionate about what we are doing. And so we channel this
disinterest by dragging our feet and stalling until the last minute. The
boredom sets in during the first few weeks of the project. Nothing much is
happening and so there is no motivation to finish. But during the weeks
leading to the deadline, there is a mad rush to finish. Some people even
thrive in the adrenaline rush. They can only finish when there is a
compelling thrill of meeting a certain deadline. The tension makes them
push themselves to the limit and deliver good work. We can all relate to
procrastinating at work.
But for men with ADHD, procrastination is chronic and habitual. It may
seem like an ordinary employee’s passive aggression of delaying work, so
people may not notice. But the procrastination in men with ADHD is quite
notorious. They may seem initially excited about starting the project. But as
the project continues, their enthusiasm wanes. They may turn their attention
to more exciting projects and park others on the side. As the weeks go by,
the project remains unfinished. The only time they get to work on it is when
they are reminded of deadlines. Some may deliver good output with the
adrenaline rush of a deadline. But most people under pressure put out
rushed and suboptimal work. This is observed by both bosses and clients,
and rate the performance of the employee poorly.
Overwhelmed With Tasks
Projects at work may present with varying degrees of difficulty. There are
some projects which are easier to do than others. Some projects take longer
periods of time to accomplish. And we may be working on multiple projects
at the same time. Companies are notorious for making sure that their
employees are multi-tasking to ensure efficiency. The more tasks an
employee can handle, the more efficient and valuable they are to the
company.
For men with ADHD, multi-tasking can overwhelm their limited mental
resources. At first, they may thrive in the variety of tasks they can work
with. But over time, they fail to lead any one project to completion. The
demands of each project may be different, and these men may fail to deliver
on each project. When it becomes too difficult, they have a low threshold
for quitting. If the task is too difficult, they will want to move on to another,
less difficult task. And when all tasks become too difficult for them, they
will want to escape the job completely.
We can also observe that these men don’t hold on to a particular job for a
very long time. They are constantly switching from one job to another. This
behavior may be due to their need for novelty and the low threshold for
boredom. This can also reflect their inability to endure difficulties. When
they come into conflict with another person, they may feel like it is easier to
look for another place to stay. When the project is too complex for their
abilities, they may prefer lighter tasks. They don’t stay too long to be
promoted in jobs and this compromises their career opportunities.
Taking on Too Many Projects
The thrill of new work entices men with ADHD to take on more jobs than
they can finish. They have a tendency to say “Yes” to anything bosses ask
of them. It is as if they also want to please their bosses and be considered
team players when they agree to accept more work. This may seem like
confidence and initiative. But this also marks a poor self-awareness of their
capacity to execute projects.
Men with ADHD also get a kick from figuring out how a new project works
or working with new people. They overestimate their ability to finish any
one work in their excitement to do something new. There may be too many
project commitments, but very few of them are executed well. Expectations
may not be met realistically given their compulsion to start different
projects.

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Think
There are many explanations why men with ADHD procrastinate. It could
be a problem with attention, as they cannot concentrate on any one project
for a prolonged period of time. The limited attention span makes them seek
new projects and dwell on exciting features of a task but makes them
neglect the boring, laborious process of actually completing the project. The
previous chapter has extensively discussed attention and how men with
ADHD can improve their focus. But procrastination can also be the result of
poor planning and execution of goals.
One of the domains of executive function is working memory. This can
come in two different forms: verbal and non-verbal working memory. First,
we will have to understand how our memory works. The way we store
memories is a function of higher-order cognition. There are three kinds of
memory storage in our brain: the short-term, long-term, and working
memory spaces. Input from our senses travels to the brain and is
temporarily held in the short-term memory, located in the prefrontal cortex.
Questions like ‘What did you eat this afternoon?”, “Who did you see five
minutes ago?” or “What is the color of my shirt now?” are all answerable
by retrieving the data from our short-term memory. It can hold information
about the last few minutes of recall. The information is quite transient and
can be forgotten easily unless it is transitioned to the long-term memory.
The information is then transferred to our long-term memory storage
facilitated by the hippocampus and the amygdala. These structures are
responsible for making sure that we retain relevant information even for
long periods of time. Questions like “What was the name of your Grade 2
teacher?”, “What was the color of your room when you were a kid?” or
“Who was your childhood best friend?” are answerable by retrieving the
information from your long-term memory.
The third kind of memory storage is working memory. It has elements of
both the short and long term memory. It can retain information about the
most recent activity you are engaged in. It is similar to the random access
memory (RAM) in computers, where information about recent activities is
easily accessed. For example, if you are engaging in a work that is about
investments, your working memory makes available to you all the
information you need about the latest stock market movements you just
analyzed, the portfolios of your clients, or how to compute the value of an
investment for a given year. Working memory allows us easy access to
relevant information so we can respond faster.
When the executive function moderates our working memory, it synthesizes
which memories will be used for a particular function. When we tap into
our verbal working memory, we use our self-talk to guide our behavior. The
verbal working memory is based on Skinner’s (1957) model of internalized
speech. The psychologist B.F. Skinner theorized that our speech guides our
behavior. We start out babbling and cooing as babies. Later on, we develop
primitive forms of speech. As children, we begin to use words to describe
and direct our actions. For example, when tying a shoelace, we say to
ourselves, “I will make a bunny hole and then pull the ears tight” to
describe the process of tying. Self-talk somehow guides our behavior. As
adults, the speech is internalized. We may not be talking outwardly, but we
may be rehearsing in our minds the steps to do a particular action. The
verbal working memory uses self-talk to direct our behavior.
Non-verbal working memory on the other hand is the capacity of people to
hold different events in their minds in the form of images (Barkley, 2016).
It is our ability to visualize different scenarios which may or may not occur.
It may involve our ability to see beyond the present situation and plan for
future events. For example, non-verbal working memory allows you to
visualize what you are going to have for dinner. In your mind, you can think
of a number of scenarios where you are eating dinner based on your
previous experiences or by planning a particular event. Non-verbal working
memory is crucial in rehearsing situations for planning instead of doing a
trial and error approach. You can plan ahead for a rainy day instead of
deciding activities only when you are already in the situation.
For men with ADHD, both the verbal and non-verbal working memories
may be dysfunctional. They cannot visualize situations way ahead of a
given time. In relation to procrastination, an employee with ADHD might
fail to pass things before the deadline because they didn’t plan the project
well enough. They underestimate the time they have and so they will not do
the work. But when the deadline is near, there is a rush to finish. Poor
visualization leads to poor planning of activities.
Experiencing difficulties in performing complex tasks may also be a
product of poor verbal working memory. Men with ADHD may be
overwhelmed by so many tasks that they may not know where to start. This
leads them to put off work until they can use self-talk to guide their next
actions. There may be a tendency to rely on others to do the work for them
as they feel incapable of handling many projects. There is less self-direction
as the anxiety over work prevents them from breaking down big projects
into smaller, doable steps.

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Feel
How do men with ADHD feel when there is so much work? Imagine a
typical desk of a man with ADHD. Their desk may represent the disorder
they feel internally. Reports may be piled on top of the other. Notes,
receipts, and other important papers may be strewn all over the place.
Leftover foods, unopened snacks, and coffee cups may litter the place. The
physical environment reflects the mental space they currently have.
With this kind of disorganization, a sense of hopelessness might be felt by
men with ADHD confronting piling amounts of work. The difficulties of a
project may overwhelm them to the point of exhaustion and self-doubt.
Even if they are extremely capable of doing the work, the sheer amount and
complexity of tasks may leave them dispirited. Anxiety and depression can
come in, further paralyzing any effort to do anything.
How do you get out of this black hole of hopelessness? Extracting
themselves from the gloomy despair of work may seem impossible.
Recruiting the help of friends is certainly a good option. Getting feedback
from peers on their work performance will help men with ADHD to check
if they are procrastinating yet again. Confiding in friends and family will
help them gather enough strength to start the work. One positive emotion
may be enough to jumpstart their rebound from the dark place of
hopelessness.
Another emotion that might influence how men with ADHD approach work
is boredom. Maybe, they just don’t like the repetitive, unglamorous parts of
the work which form the bulk of a project. The initial planning and the
novelty of new goals may excite them at first. But when it comes to
executing ideas, the work becomes more predictable and routine, making
men with ADHD disinterested. Here we need to ask them, “What is it in the
work that makes it boring?” To flip the scenario, we can ask them “What
will make the work not boring?” By posing these questions, we can
understand better where the boredom is coming from. We have to
emphasize that boredom is part of the work. Every activity will entail some
boredom. What might work for men with ADHD is to find ways to make
the boring parts exciting. Even if it is simply writing a report or making a
presentation, these activities can still be exciting only if we stretch our
imagination.

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Do
Building habits on stopping procrastination relies on the willingness of men
with ADHD to be comfortable with boredom and expand their working
memory. The following exercises may be performed to strengthen that
mindset and behavior of doing the work early.
Finish One Thing First
With many different projects simultaneously running, the work can truly be
overwhelming. It may even reach a point where the person just completely
stops because he cannot handle any more pressure. One powerful antidote
to the spiraling depression and anxiety brought about by panicking is just to
do one task at a time. Companies may glorify multi-tasking, but it can cause
detrimental effects on people who may not be equipped with handling many
things at the same time. Instead of focusing on the whole, men with ADHD
can choose one task which they can do well and finish within a short
amount of time.
That first step is the most crucial step they need to take. It could be as
simple as opening the laptop or clearing the desk. It’s difficult at all to flip
open the computer or to take away the piles of reports and rubbish on the
table. If they can do that first step, then they can definitely take another
step. One step at a time, and before they know it, one project can be
finished. By focusing on only singular, doable tasks, the anxiety and panic
may be diminished, allowing them to gain momentum.
Plan Ahead
One of the most important skills to be learned in the workplace is proper
project planning. You must be able to visualize the final look of your
project and how you will accomplish that week per week. You can start
with the end in mind. If the final output is a product presentation for a
client, visualize what kind of effect you want to have on them. With that
vision, work backward and dissect the process into manageable pieces per
week. Given that final product, how will you accomplish that given a period
of time? Constantly look ahead at what you want to achieve in order for you
to be guided.
If positive motivation does not prompt you to work, then try visualizing
how the client will react when you don’t accomplish your tasks on time.
Imagine your boss yelling at you when you don’t meet deadlines. That
vision should prompt you to avoid it altogether and work immediately. By
projecting a catastrophe, you can prepare for it way ahead of time.
Do the Boring Work First
Instead of starting out with the easier and exciting parts, dwell on the boring
parts of the work first. Train yourself in doing the less glamorous parts of
the project like reading, writing, and researching. If you can finish these
parts first, then the more exciting parts will be easier to do. Condition
yourself that you will tackle the rigorous parts first. The sooner you get this
over, the earlier you can work on parts of the project you enjoy the most.
Find ways to make the boring parts less boring. If you think that writing a
report is boring, then find something in the document that gives you new
information or provides a fresh perspective. If you feel that making
presentations is a yawn, motivate yourself by creating small challenges.
Maybe you can make the report more interesting by posting a quote that
you like or an appropriate image you found interesting. There is always a
way to spice up what is intrinsically boring, if only you stretch your
imagination.
Set Earlier Deadlines
Knowing that you have a problem with procrastination should make you
more vigilant that you are going to miss out on deadlines most of the time.
A way out of this trap is to set personal deadlines way ahead of time. You
don’t need to wait for your boss to tell you that the report is due that
afternoon. You don’t need an enraged client demanding your outputs just to
motivate you into working. You can motivate yourself by setting earlier
deadlines for yourself.
If a project is doable in a month, target completing at least a week before. If
you aren’t motivated by that, just break down the individual steps in
completing the project and create customized deadlines for that. So if you
have a presentation to a client, target researching information for a week,
then write the draft the next week. The more deadlines you set, the more
pressured you will be to do the work. Sometimes, it is by pressuring
yourself that you can shake off that boredom you feel about the work.
Don’t cheat yourself on deadlines. If you have set a particular date to finish
a task, stick to that time. Making your deadlines flexible to your mood at
the moment defeats the purpose of the exercise. Impose sanctions on
yourself if you don’t meet personal deadlines. You need to be strict on
yourself because having ADHD already impairs your ability to execute
tasks. Consequently, reward yourself if you’ve done tasks ahead of
schedule. Celebrating an early passing of a report might boost your
confidence that you can stop procrastinating after all.
Celebrate Accomplishments
When you finish a certain goal or project, make time to reward yourself.
For all the work and effort you put into a task, it is only fitting that you treat
yourself for doing a good job. You’ve expended so much energy in
accomplishing your work that you need some activity that will boost your
happy hormones and make you feel that the effort was all worth it. This can
come in the form of going out to dinner with friends, buying a small gadget
you like or eating a large pint of ice-cream by yourself. It can even be non-
material, such as spending time with your dog, or strolling in your favorite
part of the city with your loved ones.
Rewards are also meant to motivate you to stop procrastinating. If you just
think of deadlines and angry bosses screaming at you at the end of the
month, you wouldn’t be motivated to work at all. But if you will set a
reward for yourself upon finishing a task, then you will be more willing and
energized to work. The power of rewards makes people determined to push
themselves to the limit, knowing that they will receive a boost at the end of
the hard work. Harness this power by setting up mini-rewards for
accomplishing tasks.

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 Chapter 5

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 Managing Your Emotions

“Honey, please hurry up, we’re going to be late!” Devon shouted at his
wife, Olivia.
“I’ll be there in a minute, I’m just brushing up,” replied Olivia. She wanted
to look especially good for her husband on their fifth wedding anniversary
date.
“Honey, you can do that in the car. If we don’t hurry, the restaurant might
cancel our reservation,” Devon complained. He couldn’t understand why
women would take so long to prepare. It was just dinner after all. It was
their special anniversary date, but it shouldn’t take his wife an hour to get
prepared.
“I’m almost done, just some final touches,” Olivia said. She wanted her
makeup to be perfect, so she lined her eyes most carefully. Olivia wanted
this to be a memorable night for both of them.
“I can’t stand it anymore, I’ll start the car,” Devon declared. He stormed off
the house grumpily and headed to the car. The restaurant wasn’t too far out,
but he always wanted to be some minutes early for any occasion. After a
few minutes of anxious waiting, Devon began honking repeatedly.
“We might as well cancel dinner at this rate!” Devon shouted irately. He got
out of the car and stormed back inside the house.
“Honey, I’m done. Let’s go,” Olivia said, beaming from cheek to cheek.
She looked radiant in her pink dress. “What are you doing here, honey?”
she asked.
“We’re late already. Let’s just have dinner at home. There’s no point in
celebrating if we’re this late,” Devon said determinedly.
“Why are you ruining our anniversary date? So what if we’re a little late? I
just want to look extra pretty for you tonight. Let’s just go,” pleaded Olivia.
She knew her husband when he was having his meltdowns. But she
couldn’t believe he would cook up a temper on their anniversary date.
“No. It’s you who ruined this date, not me. I was ready very early and you
took your sweet time. I’ve lost my appetite and I just want to stay home,”
Devon said with finality. He headed off to the room and slammed the door
behind him.
“Did I marry a man, or did I marry a kid?” Olivia thought to herself.

Do you get angry easily? Do you feel frustrated when people don’t get your
thoughts and intentions? Do you often feel misunderstood? Men, in general,
have difficulty in handling and expressing emotions. Men with ADHD find
managing emotions doubly difficult.

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Common Problems Encountered
Children who have ADHD may seem quite antisocial and independent of
other children. Their behaviors are often disruptive and other children tend
to avoid them. A misdiagnosis of Autism Spectrum Disorder (ASD) may be
made when observing this lack of social skills and apparent disregard for
others. But in ASD, impaired social interaction is more prominent,
accompanied by reflex, repetitive actions. In ADHD, there is difficulty in
forming relationships with persons outside of the immediate family. This
characteristic persists to adulthood and men with ADHD often find
themselves at odds with other people. They are capable of intimate
relationships and close friendships. But they also have a way of turning
people off especially with how they handle their emotions. Here are some
common problems men with ADHD experience:
Exploding in Bursts
Men with ADHD have a tendency to burst out in emotion. Feelings can be
so powerful that they cannot express these immediately. There is poor
emotional regulation and they will act upon these feelings. On one hand, it
shows how they are very genuine with their emotions. What you see is what
you get. If they are really offended by a remark or a gesture that they don’t
like, it will be evident in their face and actions. On the other hand, they
cannot control these feelings. More often than not, these result in
suboptimal decisions that they regret later on. If they are extremely happy,
they may give away a lot of money in their giddiness. If they are angry, they
can make a scene, punch somebody, or destroy property. These extremes in
behavior often traumatize the people around them.
Feelings are very labile, coming and going depending on the situation. Men
with ADHD just follow that swinging of emotions, unable to control their
feelings even when the situation is not appropriate. Their response to a
situation may be exaggerated due to their poor emotional regulation. Even
if they don’t want to consciously hurt other people, they have a tendency to
do so. They are easily triggered by stressful events. Later on, they regret
their actions and seek forgiveness. But the swinging of emotions may make
their loved ones afraid of them. They never know when men with ADHD
will explode next.
Difficulty in Reading Emotional Cues
As occupied as they are with their own feelings, men with ADHD have
poor sensitivity towards the feelings of other people. They can feel so
overwhelmed with their anger or sadness that they can’t relate to how others
may be feeling about the same situation. Their reaction may sometimes be
inappropriate for a situation. When a colleague is fired from a job, they can
remark out loud, “Well, that’s one less unproductive employee for us.” It
may be their true opinion, but saying it out loud shows how they can be
insensitive to the situation. When their partner is crying, they may not be
able to empathize as much if they don’t feel sad themselves.
They may also have problems reading emotional cues. At the funeral, it
might be expected to be more somber and subdued. But they may fail to
read through this convention and crack a joke or laugh loudly during the
eulogy. The aftermath is quite embarrassing as other people will find their
behavior strange and inappropriate. They cannot read if other people are
also mad, sad, angry, or happy. They focus too much on their own emotions,
preventing them from being sensitive to others.
Dominating the Talk
Children with ADHD are often called out for speaking out of their turn.
They recite in class even when they are not called. They tend to interrupt
conversations in their desire to grab attention. This behavior persists into
adulthood. From the classroom, their behaviors persist into new
environments like their workplaces or in social gatherings. Men with
ADHD express their opinions loudly and at inappropriate times during a
board meeting, a team discussion, or a friendly reunion of colleagues. They
have a tendency to dominate the talk, expressing their thoughts the moment
they feel like it. They have a thousand thoughts running through them, that
they cannot but speak out. When another person is speaking, a topic can
trigger them to grab the limelight and say their own opinion. If they cannot
butt in, they feel so anxious and jittery about not saying their piece.
As a result, others feel offended by their interruptions. Conflicts can arise
when opinions clash, as men with ADHD are often stubborn about their
ideas. Monologues happen instead of free-flowing conversation, as they hog
the speaking time. People avoid them for poor social skills, isolating the
person even more. It can be quite lonely to have ADHD, as people feel
affronted by the attention-grabbing behavior.

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Think
As much as we think that emotions are governed by our heart, it is actually
our brain that modulates all emotions. Many structures are associated with
emotions, namely the amygdala, the periaqueductal gray matter, and the
insular cortex. These structures integrate input from the senses and the
memory to generate a reaction in the form of feelings. When we see a
birthday party, the brain recalls similar memories of happiness and thus
enables the person to feel happy. When the person watches a horror movie,
childhood memories of being scared flash back and make the person
fearful. Emotions are produced through a complex process of sense and
memory integration.
For men with ADHD, the problem is not so much on inappropriate
expressions of emotions. This is to differentiate ADHD from other mental
illnesses where the feeling may not match the situation as in the case of
depression or schizophrenia. The difficulty for people with ADHD is the
inability to modulate the response to a situation. Usually, emotions are
regulated by the frontal cortex to match a particular situation. The raw
emotion is edited and controlled by the brain to be expressed appropriately.
For example, a car cuts the lane of a man driving down the freeway. It is
annoying and ordinarily, you'd just honk your horn or express your anger
within the confines of your own car. But for men with ADHD, the reaction
is exaggerated. Their anger can be expressed as speeding up to catch the
other car, making aggressive moves on the other driver, or worse, becoming
violent upon confrontation. The anger is valid and appropriate. But the
expression of the feeling is excessive for the situation. This can lead them
to unnecessary conflicts and even arrests if not controlled.
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Feel
Emotions are our natural response to situations. We cannot dictate how we
should be feeling in a situation. But rather than acting immediately on our
feelings, the mature mechanism is to let our brain modulate the expression
of our feelings. For men with ADHD, the problem with emotions lies in two
domains: expression and control of lability.
First, we have already seen how men with ADHD have exaggerated
expressions to a given situation. The feeling can be so overwhelming that
they cannot but act on the emotion. Oftentimes, this results in a great
disadvantage to the person. In CBT, this can be addressed by helping the
person match the intensity of the emotion with the situation. There are
many intensities and levels within one emotion which should also be
accompanied by a variety of reactions. For example, anger can be expressed
in many ways depending on the situation. You can be annoyed when
somebody cuts you in line. You can be bummed when you miss the bus for
work. You can be furious when somebody pickpockets you. You can be
enraged if your partner cheats on you. All of these situations may incite
anger in a person. But each situation calls for a different intensity of anger.
Not all of the time should you punch the offending party. There is no room
for you to violently assault a person without trying more peaceful means of
settling a conflict. The more options of expressing an emotion a person has,
the more they are able to choose an appropriate reaction to a situation.
Next, emotions are quite labile in nature. One moment, you can be giddy
over winning a raffle. In just a few minutes, you can swing towards being
enraged when you realize that it was just a prank played on you. Emotions
come and go, depending on the circumstances. They are not permanent
states unless you are suffering from depression or any other mental illness.
Every person experiences feelings uniquely. The rate of change in feelings
may be different from person to person.
Given this lability, the mature approach to emotions is to control these
sudden shifts. We cannot let emotions take control over us. Rather, our
cognitive function should modulate emotions in order to target a particular
goal. Men with ADHD are prone to be swept with the lability of emotions.
CBT can greatly help them by performing exercises to induce calmness.
When we are not at extremes of feelings, we can think better about the most
strategic action. Avoiding the swings of feelings will enable men with
ADHD to master their emotions and make good decisions.

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Do
The goal is to modify our emotional states in order to promote adaptive and
goal-oriented behavior (Thomson, 1994). Both thoughts and emotions
influence our behavior. We can harness our emotions to target particular
behaviors that will enable us to reach our goal. By choosing to pause
instead of acting on our feelings, we will be able to think better about the
situation. When we want to win friends over, we should work at modulating
our emotions to also be sensitive to their emotions. Our feelings are very
powerful drivers of behavior if we can only harness them appropriately.
Here are some useful exercises to develop that habit of managing our
feelings.
Naming Feelings
The first step in managing feelings is naming emotions. You might think
that this is pretty basic. Being sad, mad, glad, and afraid are basic feelings
we’ve learned since childhood. But there is more to these feelings than we
realize. Within each basic feeling, there is a range of other emotions varying
in intensity. For example, sadness can range from upset to disappointed,
loneliness to longing, gloomy to teary, unhappy to depressed, forlorn to
melancholy. They all have something to do with sadness, but each emotion
carries a different intensity of sadness.
Sometimes, the problem with emotions is that we lack the vocabulary to
describe what we are feeling. When we don’t have a precise name for the
dominant emotion, we have a tendency to generalize it. Instead of saying, “I
am annoyed,” you can mistake the feeling to be “I am enraged.” These are
very different intensities of anger. When you are able to name the feeling
that you have, only then can you master it.
There might be instances when you have mixed feelings. It is possible to
experience two or more feelings happening at the same time. For example,
you can be excited while watching your son’s football game. At the same
time, you are also worried that he may hurt himself during the game. We
can even have conflicting feelings, wherein our emotions clash with each
other. To untangle us from the mess of feelings, it is a good practice to ask
ourselves, “ What is my dominant feeling?” or “What other feelings am I
experiencing?” Let us check our feelings constantly. The more that we can
use precise language to name our feelings, the more we can control them.
Pause and Breathe
If you are experiencing an overwhelming feeling, take time to pause for a
good while. If you feel so angry about a particular incident, close your eyes
and just mentally count to a hundred. You know that you are easily
triggered by emotions and that leads you to make poor decisions. So go
against what you normally do. Disengage the moment that you feel that you
are reaching your tipping point. If you really can’t control your feelings, try
physically staying away from the stressor. Buy yourself some time to think
and let the feeling subside.
It is a good practice to concentrate on your breathing. This will divert your
attention to something neutral. By breathing deeper and slower, you are also
letting more oxygen into your brain, allowing you to think better. Let the
running thoughts and emotions subside as you concentrate on your
breathing. Only when you are fully relaxed should you resume your
activities.
Be aware also of your trigger points. If you already know that you tend to
flare up when you have to wait in line, then just walk away. This might be
the best solution if you can’t control your emotions yet. Don’t put yourself
in a situation where you know you will just get angry easily. In time, you
can be desensitized to your stressors. But until then, avoid conflicts if you
can.
Practicing Empathy
A problem with men with ADHD is the apparent lack of empathy. This is
the ability of a person to put themselves in the situation of the other person.
We practice empathy when we can imagine how other people feel about a
certain situation. It involves setting aside our own agenda and concerns in
order to attend to others. When we empathize with other people, we
recognize that they also have feelings and opinions which may be different
from us. Our actions are then modulated in response to knowing how others
feel. By observing the actions and expression of emotions of other people,
you can have a sense of what they are feeling. You can probe this and ask
what they are really feeling. By listening to their emotions, you can also
appropriate yours. For example, listening to your wife lament the loss of her
parents makes you sympathetic, prompting you to console her. It would be
inappropriate to make jokes or bring about bad memories of her parents in
that situation.
Groen et al. (2018) found out that adults with ADHD had lower self-
perceived emotional empathy scores compared to those without the
condition. They are so caught up with their own concerns, emotions, and
thoughts that they don’t recognize how others may be feeling. They may be
so excited about an idea, they cut the conversation in order to share their
thoughts. They tend to dominate the talk because they have a decreased
level of sensitivity. Men with ADHD tend to have poor social IQ because
they divert all their attention to themselves.
Practice empathy daily to increase your sensitivity. The basic skill you need
to learn is to listen. Even if you have a great idea, pause that for a minute
and give others a chance to share their own. You might learn something
new as you listen to the ideas of others. Control the urge to cut the
conversation and observe how people give and take. There is an art to
conversation. You might think that speaking with another person is quite
simple and straightforward. It is anything but simple. Conversation allows
two people to exchange their ideas in a respectful manner. One person gets
to speak and the other listens. After some time, the roles reverse. The
conversation is like a dance between two people respecting the opinion of
each other.
Be very observant of other people. There are times when emotions are not
said but are expressed nonverbally. Your son may not be explicitly saying
that he is sad. But the way his eyes stare into space and his avoidance of
friends may tell you that something is wrong. Learn to read the emotions of
people based on the tone of their voice or their body language. Increase
your social IQ by taking a keen interest in observing other people.

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 Chapter 6

OceanofPDF.com
 Loving Yourself

“This is the most dreadful ride I’ve ever been to!” Logan thought to
himself.
He traveled on his summer vacation to the United Kingdom and France as a
solo traveler, exploring the distinctive landscapes and attractions of each
nation. It had taken him several months to plan his European tour, and he
made sure he filled his schedule with back-to-back activities. But nothing
prepared him for the long Channel Tunnel that was almost 35 minutes long.
Logan boarded the Eurostar at the Folkstone Station, excited to finally
experience the famed UK-France transport system. As a solo traveler, he
was able to manage his UK itinerary well, covering the major tourist
destination with ease. But going to France would be a difficult question.
Logan didn’t speak a single word in French. He was going to rely solely on
his Internet browsing skills and the hospitality of the French.
During the start of the trip, Logan tried sleeping. There wasn’t exactly a
view to look at, as the train was mostly underground. He put on his eye
mask and tried dozing off. He shifted his body constantly, trying to find the
right position to relax. But try as he might, Logan couldn’t sleep.
He next tried to read a book. The bookshop near the train station looked
promising and he bought himself a copy of a mystery thriller book. Logan
leafed through the first few pages, trying to immerse himself in the story.
But he found himself reading the same paragraph five times in a row,
unable to piece together the thought of the sentences. On his sixth reading,
Logan simply surrendered and placed the book back in his bag.
Logan just can’t stand the silence and feeling of being in one place for a
very long time. Fifteen minutes was manageable, but 35 minutes in an
enclosed space with minimal views for the most part was downright crazy.
Others might not seem to mind, but Logan couldn’t stand the claustrophobic
atmosphere. He began flipping his phone, browsing through his social
media. He checked his sister's page and left a few comments on his co-
workers’ posts. But after a while, Logan got bored over the endless stream
of pictures and information. He tried listening to a music streaming app, but
he couldn’t decide on a particular track. His attention span was less than
thirty seconds for any song. After a while, Logan just gave up and switched
his phone to silent mode.
“Now, what?” Logan asked himself. He had exhausted every activity he
could imagine while sitting on the Eurostar. But he still felt restless. He
wanted to walk down the aisle to relieve his restless legs, but he knew it
wasn’t allowed. He kept on tapping his feet, but the old French couple
seated in front gave him a glaring look.
“This is the worst train ever!” Logan exclaimed to himself. He could never
figure out how riding a train could be the most stressful part of a vacation.

Do you have problems controlling your impulses? Are you often accused of
lacking self-awareness? Do you find waiting in line cumbersome? The
awareness of our own thinking and feeling processes is often problematic
for men with ADHD. In this chapter, we will be exploring more about our
relationship with ourselves, and how men with ADHD can respond to that
challenge.
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Common Problems Encountered
Self-awareness is one mark of a mature person. The ability to reflect on our
own actions and motivations enables us to check ourselves and the impact
we have on other people and on our goals. With self-awareness, we can
adjust behaviors that may not lead us to our goals or put a strain on our
relationships. Knowing motivations, checking impulses, and reflecting on
actions enable the mature individual to achieve goals with more
intentionality while relating well with others.
For men with ADHD, self-awareness is one of the skills they have difficulty
with. Danckerts et al. (1999) examined symptoms of ADHD in male
adolescents and found out that they performed poorly in areas of self-
evaluation and self-reflection. Their self-concept and rating on their own
performance on tasks were significantly different from what objective tests
or feedback from other people were. They have a myopic view of
themselves, sometimes quite detached from reality, that leads them to short-
sighted mistakes.
The very fact that other people are the first ones to refer the person to a
clinician for ADHD symptoms shows how unaware they are of their
condition. There might even be denial and resistance to seek help, thus they
are diagnosed quite later. The only times when they would agree to see a
clinician is when their dysfunctional behavior has caused a significant
burden to them or to others. Even in therapies, denial and lack of awareness
persist, making progress difficult. Thus, one of the main objectives in
therapies for men with ADHD focuses on increasing self-awareness. Here
are some common problems these men encounter:
Difficulty in Waiting
Waiting in line is one of the most hated activities for men with ADHD.
They cannot stand waiting in line in a restaurant, for a dentist’s
appointment, or in traffic. The lack of other activities to stimulate them
makes them anxious. The very idea of being in a secluded space doing
nothing horrifies them. The anxiety could be so severe that they will even
postpone activities where they will need to wait. A dad could miss his
daughter’s ballet recital if it meant waiting thirty minutes before the
program started. An employee might not join his colleagues going clubbing
if it meant waiting in queues for a long time. They are willing to sacrifice a
lot of activities just so they could avoid the inconvenience of waiting in
line.
Men with ADHD would also not enjoy activities that will require them to
sit and listen for prolonged periods of time. Listening to a discussion in
class or taking part in a routine business meeting may make them squirm in
their seats as they itch to do something else than sit. If in childhood, they
can run around the hallways to ease the anxiety, this might not be
appropriate for adults. So they internalized that anxiety, their thoughts
racing inside of them, their feet tapping the ground impatiently. They can be
seen always looking at the clock, wondering when the activity will end. It
may look like daydreaming in class or having a faraway, blank look during
a meeting. They may look silent, but deep inside, they are dying to get out
of the place.
Compulsion to Do Something
The perpetual anxiety makes them crave constant activity. They need
constant stimulation to ease their tension. This can be seen as twirling pens,
chewing gum, or squeezing a stress ball during school or work. They can
stay a long while on their smartphones as the device allows them to be
visually stimulated all of the time. They want to pack their schedules with
so many activities. Weekends with nothing to do might seem like a
nightmare for them. They are always on the move as if seized with a certain
compulsion for action.
Quiet and repetitive activities will make men with ADHD uncomfortable.
Reading a book on a Saturday afternoon might not be their cup of tea.
Watching ballet or a classical concerto might bore them to bits. Even just
chatting with friends doing nothing might make them look for other
diversions. Some might have problems sleeping at night. Even at rest, their
minds are still working like crazy. It can be exhausting to have ADHD. But
the more you push them to do activities that seem restful for others, the
more they will feel anxious.
Men with ADHD can also be picky with the kind of jobs they will
undertake. Jobs which have immediate results and lots of variation are quite
suitable to their disposition. These include working in emergency situations
like cops, firefighters, stock market day traders, or emergency medicine
doctors. The thrill of the moment and the constant multi-sensory situation
stimulate their productivity. On the other hand, jobs that don’t yield
immediate results bore them to death. Occupations where there is a lot of
planning and preparation before results can be observed make them
anxious. Jobs that require long years of training like medicine, law, or the
sciences might dissuade them from even trying to undertake. This can
include research, accounting, engineering, actual science, or data
management. The very thought of being in an office, facing a computer for
hours on end makes them disinterested. The result of forcing them into
these jobs is that they will find ways to postpone the work and
procrastinate. Any activity that is repetitive will be detested by men with
ADHD.
Feeling Out of Control
A sense of powerlessness is felt by men with ADHD in controlling the
things around them. In the previous chapters, we’ve discussed how strong
emotions can push them into making regrettable decisions. They cannot
control their anger and act on it immediately, without recognizing
consequences. The transition from emotion to action is so powerful that
they feel helpless to stop acting on it. Even if they recognize that they are
going to do something wrong or harmful, they stop themselves. If you ask
them why they continue making bad decisions, they will say “I have no
choice.” This lack of control over feelings, thoughts, and actions makes
them feel miserably trapped. They cannot even help themselves even if they
want to. That realization of the lack of control may be the first step that
would prompt them to seek help from others.
Men with ADHD also are also challenged in taking responsibilities. If a
disaster happens, they will blame anybody and anything else besides
themselves. If a project fails, they are going to blame the unreasonable
deadlines, the incompetent staff, the fickle clients, the bad Internet
connection, or the personal vendetta of their bosses. They see themselves as
victims of a chain of events that they have no agency in changing. “He
made me do it,” “she forced me to do this,” or “bad luck just hit me,” are
common excuses they offer for lapses in a certain task. Again, we see here
the lack of control these men feel over their lives. ADHD can be a
disempowering condition for men.

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Think
What could be happening in their minds as they feel these compulsions? A
defining characteristic of ADHD is the lack of behavioral inhibition. This
refers to the ability to control and block reflexive behavior. It is broadly
defined as action without foresight (Winstanley et al., 2006). Whenever we
feel the urge to do something, we are able to delay or even prevent our
impulse to act. Mature individuals can control that process of feeling,
thinking, and acting at every stage. The prefrontal cortex is responsible for
this behavior inhibition. Reflexive actions usually lead to poor decisions.
Having a well-developed behavior inhibition function enables individuals to
respond appropriately to a situation.
Men with ADHD have poor behavioral inhibition. If they were subjected to
the classic ‘marshmallow test,’ they would surely fail. They cannot gauge
the benefits of a short-term or a long-term reward. When applied to
emotion, they are not able to restrain themselves from acting immediately
on their feelings. When they are angry, they will just kick, punch, or yell
out their anger. When they are excited about a project, they will definitely
exhibit it. This can cause a number of problems, as we have seen
previously. Cognitive behavior therapies (CBT) rely on strengthening the
behavioral inhibition function in men with ADHD.
Another cognitive aspect they are challenged with is delaying gratification.
This is one framework in which we can see behavioral inhibition leading to
long-term benefits for the person. Twito et al. (2019) defined it as “the
ability to postpone an immediate gain in favor of greater and later reward”.
We can glean a couple of insights on delaying gratification and ADHD from
this. First, in a given situation, a person is faced with a couple of choices to
choose from. There is that option to take an instantaneous pleasure or
postponing pleasure for a long-term gain. The point here is that there are
different choices we can make. In men with ADHD, this basic realization of
the plurality of choices seems lacking. They cannot but see just one option:
to take instant pleasure. If they are faced with a conflict, they will just want
to quit altogether to be rid of the pain of dealing with the situation. They
cannot move away from their emotions and see that there are a variety of
other choices they can make.
Next, Twito et al. (2019) mentioned immediate versus a later reward. The
temporal difference between now and later is something that men with
ADHD will find problematic to distinguish. Even the idea of ‘delaying’ or
‘postponing’ is all in reference to time. Men with ADHD have difficulty
with this because they have that intrinsic distaste for waiting. They cannot
conceive of a future moment because they are just so caught up with the
concerns of the present. And we know how tragic that would be when long-
term goals are sacrificed for short-term gains. A company that focuses on
short-term benefits will not last if they don’t have a five or ten-year plan
that will guide them. When there are challenges to a certain project, the
tendency is to react to the immediate loss and not hold on to the broader
picture. No significant progress then is possible when we only look at goals
with a narrow perspective.
Lastly, there is mention of a ‘greater’ reward, usually accompanying long-
term endeavors. The issue here is comparing the substantial quantitative or
qualitative gain from waiting. When we delay gratification, there is an
assumption that there is a material and substantive value in waiting. A
doctor invests many years of training in order to save lives and earn a lot of
money at the same time. He is willing to do the arduous hard work because
he recognizes a future, substantially greater benefit in his training. Men
with ADHD have problems with comparing the substantial value of
endeavors. They are challenged in weighing which option is more valuable
than others. Is eating this chocolate more advantageous than eating a salad?
Is smoking yet another cigarette stick worth a lifetime of lung problems? Of
course, we don’t always equate long-term endeavors to greater rewards. It
pays to reward ourselves with simple pleasure every now and then. But the
problem with men with ADHD is that they have a compulsion to choose the
simple pleasure now rather than the greater benefits of delaying
gratification.
In CBT, these three issues with control and self-awareness are targeted to
empower men with ADHD. One, they are taught that they also have choices
in each situation. There is no such thing as “I had no choice.” By thinking
more deeply about a certain situation and setting aside their immediate
feelings, they can realize how varied their options can be. Instead of acting
on their anger, the person is made to enumerate different courses of action
that are possible. The therapist will challenge the person to think of as many
alternative decisions given a certain dilemma. For example, a man is feeling
down because he got bad feedback from his boss for his work. Aside from
quitting and wallowing in self-pity, what else could he do about the
situation? He could either ask his employer about specific ways he could
change to make the project better. He could undergo further training to
enhance his skills which may help him make better reports. He could
manage his time better so that he doesn’t pass projects beyond the deadline.
He could ask for help from other employees on how to improve himself. By
sitting down and reflecting deeper on his situation, the person will realize
just how many options he has in facing a certain conflict. With a variety of
choices to choose from, the person can make better decisions.
In therapy, the person is led to compare the differences in temporal and
substantive valuation of different choices. The therapist asks the person
“What are the pros and cons of option A?” “What are the pros and cons of
option B?” and so on and so forth. This exercise in comparing the pros and
cons of different choices will allow the person to see the overall value of his
choices. It will require him to pause and think longer about each option
more carefully instead of acting immediately on a whim. The exercise will
help them appreciate long-term endeavors more than the instantaneous
pleasures. In CBT, the person is helped by having a wider perspective of his
situation.

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Feel
What could men with ADHD be feeling when they act on their
compulsions? What motivates them to keep on repeating suboptimal and
incriminating decisions? One prominent feature behind compulsions is the
feeling of anxiety. As we have mentioned in the other chapters, men with
ADHD are prone to have mental disorder comorbidities, and one of the
most common is anxiety. They are distinct mental disorders and they often
influence each other. The lack of attention and the hyperactivity of the
person with ADHD lands them in situations where they encounter a lot of
problems and conflicts. This in turn makes them more anxious. The anxiety
exacerbates the inattention and the hyperactivity, in a destructive cycle. But
where could the anxiety be coming from?
A deeper understanding of anxiety in men with ADHD is rooted in the
problem of self-esteem. This refers to our concepts and feelings about
ourselves (Michal et al., 2004). Self-esteem is how we evaluate our own
self-worth, a subjective affective and cognitive attitude towards our intrinsic
value. We have positive or high self-esteem when we consider ourselves as
ultimately good, capable, and lovable in spite of our flaws. Negative or low
self-esteem is when we consider ourselves as bad, useless, and unworthy of
being loved. Our thoughts and feelings about ourselves can affect our
behavior.
Interestingly, children with ADHD were seen to have high self-esteem
(Hoza et al., 1993). This causes them to overestimate their abilities and
commit careless mistakes. They feel that they can read and write so well
that they don’t double-check their answers or read instructions carefully.
This inflated sense of self makes them more prone to errors. Cook et al.
(2014) found out that adults with ADHD tend to have lower self-esteem
compared to those without the condition. One, this negative sense of self-
worth may come from the negative messages surrounding their abilities in
work and in relationships. The repeated poor performance feedback,
rejected proposals, and termination from work deeply impact these men and
their egos. They interpret the feedback on their abilities as a reflection of
their worth as persons. A bad employee equals a bad person. In
relationships, the rejections from intimate dates, the uncontrolled emotional
outbursts, and the lack of social support make them feel that they are
unlovable people. They desire to have friends and to have a loving family.
But their peculiar behavior hurts and alienates the people around them.
Thus, they begin to believe that they are not worth loving.
Next, they are not able to deal with adverse outcomes with emotional
maturity. Everyone is faced with their particular life stressors but men with
ADHD seem to cope with these poorly. Unemployment, breakups with
loved ones, failures in school, mounting bills, or death in the family have a
large emotional impact on them and they are not able to process these.
Because they have poor self-awareness, they don’t realize how these
emotions are affecting their behavior. The negative emotions of anger,
depression, and anxiety all fuel their negative self-concept. They cannot just
shake it off, and move on quickly like others. There is a tendency to brood
over these negative feelings and this impacts how they see themselves.
Finally, men with ADHD have poor self-esteem because they have
inadequate support from services. In the first place, being men, they already
have poor health-seeking behavior. Having ADHD exacerbates this because
it makes them less self-aware of their condition. These two factors make
men with ADHD less willing to seek help about their condition. Instead of
getting better, they try to solve their issues on their own, often with futile
results. Their behavior estranges many people, cutting off their social
support system. Instead of being sympathetic to their plight, people regard
men with ADHD as weird, strange, or annoying. Having ADHD makes
men more isolated and depressed, fueling their low sense of worth.
In CBT, self-esteem is an issue well-tackled in men with ADHD. In therapy,
they are confronted about their concepts and feelings about themselves.
They are made to understand why they have a low opinion of themselves
and how they can change that. These men are taught how self-esteem is not
just based on abilities and external stress situations. They are made to
accept that they are good, capable, and lovable just as they are. It might be
difficult to accept but therapies help men with ADHD increase their self-
esteem and value themselves better.

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Do
Before men with ADHD can really relate well with others, they first have to
learn to love themselves. This is only possible when they are aware of their
positive and negative traits, as well as their motivations and compulsions.
Awareness will make these men understand how some of their behaviors
may be dysfunctional, but does not make them in any way unlovable or bad.
By practicing self-love and awareness, men with ADHD can help
themselves to be better.
Appreciating Silence
The waiting can be terribly boring and anxiety-inducing for men with
ADHD. But a healthy relationship with silence must be established. There
is a lot they can gain from just being silent and doing things in silence.
Perhaps, the anxiety comes from a misconception about silence as the
absence of activity or sound. Silence is not nothingness. It is actually a
fullness that allows people to be themselves. Instead of panicking when
things become too silent, men with ADHD can be guided to appreciate just
how dynamic and healing silence can be.
First, silence provides a space to listen. As we have seen in previous
chapters, men with ADHD have problems with listening to others because
they are too occupied with their concerns. In learning to outgrow this, men
must practice listening by being silent. When we quiet ourselves, we can
actually hear so many things. We can hear birds chirping in the distance. We
can hear the wind howling through the window. We can listen to the
different chatter of people around us. Silence is never boring, if only we
look at how the world is beautiful and try to communicate that to us.
Next, silence helps men with ADHD breathe. When you focus on your
breath by being silent, you are putting more oxygen in your body that will
help your brain think better. By breathing out, you are releasing bad toxins
in your system such as anxiety, depression, restlessness, and self-pity.
Breathe the good in, breathe the bad out. When we are silent, we can notice
our breathing more and more. We become more aware that we are alive as
we breathe. There is much we can learn just from focusing on breathing and
keeping still.
Finally, silence allows us to listen to ourselves. The noise of the world fills
us with so much negativity and criticism about our weaknesses. If we only
subscribe to that noise, then we really are going to be more anxious and
depressed. By dwelling in silence, we can allow ourselves to be heard.
Listen to your body, aching from pacing through and fro. Listen to your
heart longing to find intimate friendships. Listen to your angry, sad, happy,
lonely, feeling self. There are so many thoughts and emotions inside of us,
waiting to be heard. Let silence be the safe space where you could be your
truest self.
Keeping a Journal
If your mind is always active, why not document it? Journaling your
insights for the day will occupy your time and keep you stimulated. You can
write whatever thoughts and feelings you experienced for the day in a
handy journal. If you feel tense in a certain situation, just grab your diary
and jot down notes on your anxiety. If you feel excited about a certain idea
and you don’t want to overwhelm people with it, use your notebook to
channel that energy. Instead of acting on your emotions, pour out your
anger by journaling. Turn that boundless energy into something productive
by documenting the thoughts running through you.
Make this a daily habit, and not just something you fancy in certain moods.
By making a daily habit of keeping notes, you are forcing your brain to
remember. This will help you increase your verbal and non-verbal working
memory which may be deficient in men with ADHD. From what you ate
during breakfast, to a memorable conversation you had in the morning, to
the highlights of the meeting in the afternoon and your overall feeling for
the day, journaling will help you jog your memory and increase your
attention. This practice may help you to learn certain things about an event
that only happens when you’ve looked at it from a different perspective.
Keep journaling daily and increase your capacity to remember.
The exercise of keeping a journal will allow you to increase your self-
awareness. When you read back at your entries, you may be seeing yourself
from another angle. You might notice some things about your thoughts and
emotions which you didn’t realize when you were at the moment. Reading
through several entries might also help you notice certain patterns of
behavior. You might realize how you easily become angry when you are
exposed to a certain trigger. The journal acts as a mirror, reflecting your
past to your present self. The process of reading allows you to befriend
yourself. Notice not just the negative aspects of your behavior, but also your
good thoughts and actions. Self-awareness is not just about nitpicking and
zoning on your deficiencies. It is an acceptance of yourself, all the good, the
bad, and everything in between. Slowly, you might even love yourself when
you allow your journal to see how good a person you really are.
Finding Your Passion
Given that you have a condition, celebrate it. Find a job that sparks your
passion instead of forcing yourself in what others feel as conventional. Your
family might be pressuring you to take a normal 9 to 5 office job, a regular
job in front of a computer, sitting at a desk for 40 hours a week. But that
might not be you. The negative feedback from work might be a sign that the
job isn’t working for you. The more that you force yourself to do something
that bores or terrifies you, the more that you will not perform well. You are
dragging the company down if you don’t see yourself being alive in what
you do.
Find the job or activity that really lights your fire. If you feel that singing or
music is your passion, go for it. With your unquenchable energy, you can
easily excel in sports or in performance arts. If your mind is stimulated in
gaming, maybe you can consider programming or game development as a
career. You don’t have to fight ADHD. You can make it work for you. Find
jobs that can accommodate your boundless creativity and energy. Of course,
any job will still require you to be attentive or to control your hyperactivity.
But at least, working on your passion will motivate you to do well in that
activity. Pour yourself into your passion, and that can already be in itself,
healing for you.

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 Chapter 7

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 Translating Goals Into Actions

“Harold, when will you ever launch your business?” Greg asked his friend
over some drinks.
It was their weekly Friday evening routine, just hanging out at a bar and
unwinding after a grueling workweek.
“I don’t know, I’ve never given it much thought, to be honest,” Harold
confessed.
They were on their first beer of the night and they were enjoying the vibe of
the weekend bar scene.
“You’ve been a sous chef for the same restaurant for the last ten years.
You’re not exactly getting any younger. Shouldn’t you pursue that
restaurant you’ve always been talking about?” Greg asked.
He had been visiting his friend’s steak house diner and he knew Harold
could make a world-class menu. And Harold was always talking about his
dream restaurant where he would be cooking his own signature dishes.
They would talk about this endlessly on Friday nights when they got
together and caught up.
“I just don’t know how to get it started. It’s nice talking about it, and I get
worked up just trying to imagine having my own restaurant. But when I’m
already sitting down, planning exactly what to do, the dream crumbles,”
Harold says.
He had some very ambitious ideas about his dream restaurant. Harold
would tell Greg about an Asian-inspired steak, a lemony Greek-inspired
sauce, or a crispy Lyonnaise potato side dish he wanted to have on his
menu. But when it comes to executing these dishes, Harold was always
stumped at even starting.
“Maybe, you have too much on your plate. Try making one dish you’ve
been concocting in your mind and you could go from there,” offered Greg.
Listening to Harold was quite tough for Greg. Harold had so many uncanny
inventions in his mind, but he never got around to executing even a fraction
of it. Greg was disappointed at how such talent could go to waste.
“I’ll try. My mind is always racing with ideas, I don’t know how to control
it completely. I have this idea for a dish, and then the next minute, I have
another. I get excited about a particular idea for a sauce, and then the next
day, I feel it’s a failure. All of these thoughts keep racing in my mind, and I
just don’t know how to pick one idea to run with. What should I do?” asked
Harold.
“Just pick one idea, and then start from there. You have to learn how to
block excess ideas, no matter how good they may be,” reasoned Greg.
“I don’t know, man. Staying with one idea bores me. I like the excitement
of discovering a new dish or imagining a new presentation,” Harold said
dreamily.
Their third bottle of the night must be kicking in.
“One idea executed well is better than a thousand theoretical ones,”
declared Greg.
The two continued enjoying their night, talking about their dreams. Greg
could only wish Harold could remember his advice the following day.
Do you easily get distracted at work? Do you set goals for yourself but
repeatedly fail? Do you start projects really well but end up not finishing
the work? Problems in goal setting and execution often hound men with
ADHD. In this chapter, we will help you narrow down the goals you want
to achieve and develop good habits to carry these to execution.

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Common Problems Encountered
Goal setting and execution make work life challenging for men with
ADHD. In employee feedback, they are often praised for their good plans
and impressive roadmap. But when it comes to actually doing the work,
these men often don’t deliver. It could be because they are overwhelmed
with the number of tasks they take or they keep on procrastinating until the
last minute. Repeated negative employee feedback may demoralize and
lead them to underperform further. Here are some common problems men
with ADHD have in terms of executing goals:
Setting Too Many or Too Ambiguous Goals
The expected endpoint of the person may not be met if there are too many
goals to start with. If the employee wants to attract 50 new clients, finish a
Master’s degree, learn how to code, finish a dozen accounting reports, and
develop a new business idea all in one month, then it might not be
reasonable to expect him to accomplish everything perfectly. He has to give
up some things because he is limited. He can only do so much in a month.
Overexerting himself over too many goals will only leave him more tired,
compromising the quality of everything he does. In the end, nothing gets
accomplished.
The solution is of course to narrow down the goals into one or two doable
ones. Diffusing your energy into many different tasks will not accomplish
anything with high quality. But focusing your attention and creativity on
one singular project will ensure that the project is done well and will be
finished. It is better to have one project done well than different projects
started but not completed. It entails a skill of knowing which goals to
prioritize and which ones to discard for the moment.
The problem may also arise from making goals that are ambiguous. For
example, men with ADHD may want to get better. But what does that
mean? Get better at focusing and attending to details? Better at managing
his time in the office? Better at controlling his emotions? Better at dealing
with his hyperactivity? If the goal is too ambiguous, then the action points
are so varied. The expectations on the endpoint are too high but the
direction set does not promote a clear direction to be accomplished.
Making goals specific will remedy this problem. When the goal is specific,
it can provide a clear direction in which the person will move towards. Out
of the many interpretations of ‘better,’ the person with ADHD can select
which one he wants to focus on. The more specific the goal is, the more
guided the person will be. The goal can be broken into small, individual
steps that the person can take in order to arrive at his goal.
Losing Momentum
While some jobs might take time to take off, people usually pounce on the
momentum to finish. Faced with a deadline, people would usually
concentrate on the task at hand, determined to accomplish the project. Some
would even skip meals just to save time and focus on finishing. Others
work late hours at night, not stopping until the last presentation slide is
perfect. There is a certain force that motivates people to just accomplish the
work they need to do.
For men with ADHD, this momentum can be derailed for many reasons.
They may already be concentrating on the work, accomplishing several
outputs. But one major distraction can offset that momentum. Another task
deadline, a conversation with a colleague, a negative comment from a boss
will send them in a different direction, unable to return to their
concentration. The short attention span does not allow prolonged focus on
one activity for a very long time. It can be frustrating, seeing how far they
have accomplished already until the distraction happened. It is hard to
return to the work, as the energy has been dispersed all over other interests.
Bogging Down During Conflicts
When faced with a major setback or problem, men with ADHD have
difficulty in troubleshooting. They have a fixed way of doing things.
Reports are to be formatted in a particular way or projects are designed in a
certain manner. But when something new happens, they can get flustered.
Their set ways are disturbed to a point that they cannot proceed any further.
If a new problem arises, they will try to solve it using their usual methods.
But when these don’t work, they are simply stumped. Projects become
delayed because of this troubleshooting difficulty.
Anticipation is also problematic for men with ADHD. With limited
foresight, they can only focus on the present concerns. Measure reactions
based on what is currently happening. They cannot anticipate that certain
problems may occur given the current setup they are working in. For
example, they may not be able to imagine if an employee resigns and how
that will impact a project. They cannot think of a scenario where a client
will not avail of their products after years of patronage. When the dilemma
happens, they are at a loss on what to do. There is no Plan B, Plan C, or
Plan D because they can only entertain Plan A. It is a problem of
imagination when they cannot project consequences months or years ahead.

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Think
The last executive function to develop is reconstitution. Freides (2002)
described this as “a group of executive functions involved in the creative
potential to solve problems.” Barkley (1997) first discussed this concept in
relation to people with ADHD. He said that the condition of ADHD
prevents people from finding solutions to a problem by selecting
alternatives, anticipating events, or drawing from past experiences. He
divided the process of reconstitution into two: analysis and synthesis.
Analysis refers to our ability to break down sequences of events or
messages into parts. Men with ADHD have problems executing a goal
because they cannot break a goal into doable, small parts. For example, a
person sets the goal of losing two pounds per week or a total of eight
pounds in a month. He can be so motivated with the goal, imagining how he
would look when he is eight pounds thinner. But he doesn’t know exactly
how losing weight happens. He is stuck with the goal, but he can’t get
around to working towards it.
By using analysis, we can break a big abstract concept into smaller, doable
processes. In the previous example, we can break down the big goal of
losing weight in a month into smaller, doable activities in a day. This would
mean eating smaller meals with fewer carbohydrates. It could involve going
to the gym and exercising for an hour three times a week. Losing weight
would mean cutting down on desserts and replacing them with healthier
alternatives. When the goal is broken down into simpler parts, it becomes
so much easier to do. Reconstitution allows us to analyze goals to make
them more doable.
Synthesis is the reverse process of analysis. We are able to synthesize when
we can manipulate smaller units to construct or reconstitute entirely new
messages or strategies. It is making sense of different, smaller processes
that will lead to the outcomes we desire. By enrolling in a painting class, by
buying a canvass, brushes, and acrylic paint, by picking a model or a
picturesque spot, the person is primed to paint. The individual actions make
more sense when they all contribute to the overall goal which is for the
person to be able to paint. The skill of synthesizing enables us to make
sense of individual actions and unite them to pursue a goal.
Men with ADHD have poor analytic and synthetic skills, preventing them
from reaching their goals. The goal may be identified, but they don’t have
the analytical skills to break it down into doable processes. Or they cannot
make sense of different tasks that could eventually lead to completing their
goal. In CBT, the person’s analytical and synthetic skills are developed. The
person is challenged to identify a goal and come up with ways in order to
achieve it, step by step. When the person sees how individual steps lead to a
goal, they will be more motivated to focus on accomplishing each mini-task
more purposefully.

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Feel
One of the stumbling blocks to achieving goals for men with ADHD is self-
doubt. In the previous chapter, adults with ADHD have low self-esteem,
thinking that they are not capable of being good, talented, and lovable. In
terms of achieving goals, doubting the self is the more prominent
dysfunction. Previous experiences have reinforced the idea that they will
always fail in whatever they do. The gloomy attitude towards the self makes
them less inclined to perform well at work, further compromising the
quality and completion of their projects. These men feel that whatever
training or effort they put into their work, they will simply end up short of
achieving their goals.
There is also a feeling of inadequacy in these men. They feel that they are
always lacking something, whether it is a skill, trait, or disposition they feel
insecure of. This comes mainly from comparing themselves with other
people. They look at how others are able to finish their work, produce
excellent outputs or get praises from superiors. There might be a hint of
envy at the good fortune of other people. They cannot see that they are also
talented and skilled like their peers. They can only think of how bad and
dysfunctional they are in comparison to others. Social media exacerbates
this insecurity. As they see how others are buying a new gadget, flaunting a
new car, eating at a new restaurant, dating a celebrity, they cannot but feel
bad about themselves. “I have ADHD so I am less than them,” seems to be
a recurring anthem.
In CBT, the sense of insecurity, inadequacy, and self-doubt are addressed.
Instead of focusing on bad behaviors, the first step in therapy is to console
the person that he is intrinsically good. This lays down the foundation for
healing. When the person is convinced that he is good as he is, it will make
him more willing to invest in making himself better.
In therapy, discussions about the past must also give way to thinking about
the future. Sometimes, dwelling on past mistakes may make a person too
depressed to change anything. While it is healthy to review the past once in
a while, focusing too much on its negative aspects will only make us more
guilty and insecure. There is nothing we can do about our past and choosing
to stay with it will not do us any good. A way out of this depressed thinking
is to shift our perspective to the future. Tomorrow is another day to prove
ourselves. The future provides endless opportunities for us to change our
behavior and try out in achieving our goals. When men with ADHD are
asked to dream and focus on their goals, they are more inspired to move
towards accomplishing them. Sometimes, a different perspective is all they
need to make them motivated.

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Do
It is possible for men with ADHD to accomplish anything they set their
minds into. They have such incredible talent and intelligence, that when
harnessed well, nothing is impossible. Men with ADHD should never forget
how awesome they are, in spite of what everybody else thinks them to be.
But, they can only manifest that great potential by developing good habits
on translating goals into action. By practicing these activities for some time,
men with ADHD will become unstoppable in whatever they aim for.
Clear Out Your Desk
Oddly enough, one of the most effective means of working towards a goal
is to clean your desk. Make it a point that at the start of your workday, make
sure that your desk is clear from all clutter. Throw away papers, plates, or
coffee cups you aren’t going to use anymore. If there are important papers,
stack them in near piles or place them in their proper filing cabinets.
Remove post-its or other notes you’ve stacked on the table that you don’t
need. Make sure that you start your day with an empty, clutter-less desk.
How will this simple act affect your performance? Psychologically, having
a clean desk translates to a clear mind. The physical environment affects
your internal mental space. If you have a clean desk, you are going to think
more clearly about your goals and plans for the day. It is like having a blank
slate in your mind where you can now fill with the necessary daily to-do’s.
The importance of having a clearing space, both physical and mental, can
never be underestimated. Though some people say they work best when
they see clutter, it is but a poor excuse for cleaning up.
When you throw away the unimportant stuff you have on your desk, you are
removing distractions that can derail your momentum. You may even
uncover some missing papers and items which are important to your current
work. The act of housekeeping helps you organize both your things and
your mind. Physically placing things in their proper locations helps you
mentally rearrange the clutter of ideas inside you. You can think about your
problems much better if everything is in order. You don’t need to panic
when you need to look for anything. You know where things are and thus,
you can just focus on doing the job for the day.
Prepare a Plan B
When facing a problem, it is always more prudent to think of a plan B, or
even multiple alternative ways of solving the issue. Assume that something
will always go wrong and so be prepared for several scenarios. Anticipate
that issues may arise so that you can already plan a backup when it happens.
When it doesn’t, then well and good. But when it does, at least you already
have a definite course of action. You’d feel more secure knowing that
you’ve covered everything that might possibly happen.
Sometimes, issues can arise spontaneously. Even your Plan B might not
work. Don’t panic when this happens. Welcome new challenges with
excitement instead of anxiety. Given your hyperactivity, you can definitely
find ways out of your dilemma just by focusing on the problem instead of
the emotion. Channel your energy, not into getting worked up by feeling
tensed or hopeless, but by looking at the problem from different
perspectives. For example, your client rejected your offer because your
price was too high. Instead of giving up, find creative solutions that will
benefit you and your project. Maybe you can offer them freebies or bonus
packages with the same amount. Maybe you just need to present your case
better so they’d understand why your services or products are pricey.
Maybe you just need to understand what your client needs. Problem-solving
is an art you have to learn to appreciate. Our usual methods may not always
work. So welcome the challenge of being imaginative and playful when
confronting new challenges.
Breaking Big Problems Into Small Units
The skill of analysis is crucial to translate goals into actions. Sometimes,
the goal can be so daunting and intimidating when we focus on it. It only
becomes more doable when we break it down into smaller processes. For
example, an insurance agent has to deliver $500,000 worth of insurance
plans in a year. If you just focus on the $500,000, the goal will seem
impossible to do. How can you get half a million dollars in a year? If you
set your focus on this target, you might just abandon it because it is too
ambitious and impossible.
A way out of this is to break down that impossible goal into small, possible
units. The amount of $500,000 in a year translates to $8,334 in a month.
This figure seems more doable if you see it from a month’s perspective.
How many clients can you get who will be able to buy plans worth $8,334?
Would one client do it? Might be impossible. Out of five people you talk to,
probably three will consider buying and only one will eventually buy. So try
talking to 50 people and ten of them will buy an insurance plan after your
pitch. Talking to 50 people in a month translates to one to two new persons
per day. Isn’t that more manageable? Talking to two persons in a day will
help you gather enough clients for a month who will eventually buy
insurance plans amounting to your desired goal. Isn’t that easy and doable?
When we lay down the process of achieving goals, then it becomes more
possible to do. Any project can be done only if we think about the entire
process that will lead us to accomplishing it. Analyze your goal and start
working towards it, one step at a time.
OceanofPDF.com
 Conclusion

Albert Einstein was reported to have said the following quote “Everybody
is a genius, but if you judge a fish by the ability to climb a tree, it will live
its whole life believing that it's stupid.”
Seems pretty easy for a genius like Albert Einstein to say. But his message
applies to everyone who feels different, especially those with ADHD. While
the world may bombard them with many negative messages about their
behavior, perhaps the standards of the world are just different. Inside every
man with ADHD is a genius, waiting to be unleashed. You have as much
intelligence, wit, talent, and goodness as any other person—capable of
making your goals into a reality. It is hard to realize this especially if you're
constantly hounded by your poor performance history in school or at work.
It is hard to feel special and capable if the people around you don’t trust that
you will deliver. And it is especially hard to accept our inner genius if we
don’t even trust in our inner goodness.
ADHD is a debilitating condition. We need all the help we can get in order
to overcome this condition. We need the help of clinicians in order to
diagnose and prescribe treatment plans to make us more functional. There
are medications and therapies available for us to control some of its
symptoms. The support of friends, family, and colleagues is crucial in order
to succeed in our endeavors. But most especially, we have to learn to love
ourselves and the wonderful gifts we were endowed with. ADHD is not a
defect in character. You are just a little more inattentive and hyperactive
than most people. It is a condition you need to live with and work to your
advantage. Think of yourself as possessing this boundless energy waiting to
be used productively. There is a fire raging inside you, causing all this
tension and anxiety, but also all these great ideas and enthusiasm. Fires left
uncontrolled can consume you, your work, and all your relationships. But
an inner fire that is soothed with control, love, and direction will
accomplish almost anything you set for yourself. The world needs to
experience the genius that is. Show them how having ADHD makes you
especially gifted.

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 Leaving a Review

As an independent author with limited marketing resources, reviews for my

books are essential in order to survive as an indie writer. New works of
literature get published daily, so there's no guarantee that any given work
will be successful. Your review can help authors like me grow and share
their knowledge with more people.
If you enjoyed this book, I would really appreciate your honest feedback.
You can leave a review by going to https://edgarwise.com/review-men-
with-adult-adhd. Your feedback is important to me so I can find out what
you like and don't, which in turn helps me make better decisions about my
writing style.
Thank you for your support,
Edgar

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 About the Author

Edgar struggled with severe shyness and lack of self-confidence growing

up, which compelled him not to express himself in school for most of his
childhood. Despite his straight A's in high school, he felt he had nothing to
offer the world. The stress of self-doubt and the fear of rejection caused him
to lose interest in human connection, which is important for living a
meaningful and happy life. Without the necessary support system, Edgar
was left with no guidance. This resulted in slow growth and a lack of
motivation, which later set off anxiety and depression.
He knew that he had a problem and needed help but did not know where to
begin or who could help him. He turned to books, seminars, and courses. It
wasn't until he started applying everything he had learned that his personal
transformation finally ensued.
After a series of successes in relationships and career, Edgar began writing
books for people who were dealing with similar problems he once had. He
started by researching methods to help himself, and he now has a deep
understanding of how other people can be helped as well. He discovered his
passion for assisting others in coping with the same issues. He dedicated
himself to researching and sharing techniques to help others improve their
lives in a variety of approaches, using both personal experience and
scientific research.
As a writer on the topic of self-help and self-improvement, he has helped
many people learn how to better take care of their lives, improve their well-
being, and build meaningful relationships. His work discusses how to lead
an emotionally healthy life and be on better terms with oneself, thus
improving one's relationships with others. He is always looking for new
ways to improve his own life and the lives of others. He provides tips and
resources in areas such as self-care, self-confidence, and communication.
He enjoys taking walks, cooking healthy food, listening to audiobooks, and
hanging out with friends and family in his spare time.
Check out more books on his Amazon profile -
https://www.amazon.com/author/edgarwise

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