Regardless of their work situation, most adults eventually need to manage their own household. For many young adults, the tasks of household management are initially frustrating and somewhat difficult, but mostly mas tered without serious problems. For young adults with ADD syndrome, however, these tasks often tax their impaired executive function abilities in ways that can become highly problematic.
One twenty-seven-year-old junior high school teacher sought treatment after studying about ADHD in a graduate course she was taking to fulfill requirements for a master's degree. Arriving thirty minutes late for her first appointment because she had lost the directions mailed to her, she apologized and then explained:
I need to get evaluated for ADD because I know I have it and it's really messing me up. Maybe if I get the right medication, things will get better. In this graduate course we just studied about ADD and every symptom on the list is something that has been a problem for me all my life. I'm terrible about planning and organizing. I can't stay focused when I read. I never remember what I've read. I've got a great memory for things from a long time ago, but my short-term memory has never been any good. I'm the world's biggest procrastinator, always late with everything. I got through my undergraduate degree, just barely, but now I'm really struggling with this graduate course. I can't keep up with the reading and the tests are really hard. I haven't even started yet on a big paper that is due in three days.
I need to pass this course because I need more graduate credits to earn more money. And I desperately need more money because my financial situation is a mess. I just got an eviction notice from my landlord because I'm three months behind in my rent. And the leasing company is threatening to repossess my car if I don't pay up on three back payments I owe them. On top of that, I'm driving now with no insurance on my car because I haven't kept up with paying that either. I've lost two department store charge cards because of late payments and I'm up to my neck in credit card debt. Oh, and I haven't filed income tax for the past two years, even though I want to get it done because I should be getting a refund.
I hope I don't have to move because I like my apartment. Besides, my place is such a mess, I could never get it all packed up. I'm totally disorganized with piles of stuff all over the floor and the tables and the chairs. There's barely enough clear space for two people to sit and eat a meal or watch TV. I always take good care of my appearance, but at home I'm such a slob. My sink is always full of dirty dishes and I never do laundry until everything I own is dirty and I have nothing left to wear. Sometimes I just go out and buy some new clothes so I can put off doing the laundry for just a little longer.
This intelligent, witty, vivacious teacher was well liked by her students and respected by her colleagues, but she had great difficulty meeting the demands of her graduate-level course and in managing her household routines and finances. Her parents had provided "loans" to bail her out of several financial scrapes, but their resources were limited and she recognized that she needed to manage her own money, time, and stuff in a much better planned and more responsible way.
During our evaluation, this teacher described her repeated efforts to plan a budget so she could meet her expenses in a systematic way. Always she found herself sabotaging her good intentions by impulsively buying new clothes or choosing to go with friends on expensive vacations she could not afford. Both her apartment and her leased car had been selected too much on the basis of how desirable they were without enough attention to the high monthly payments required. She had calculated her expenses for these items on the basis of her total monthly paycheck without taking into account the amount needed for utilities, groceries, gas, and other recurrent expenses.
The results of her evaluation indicated severe ADHD, which responded well to appropriate medication treatment. With that treatment she was able to organize her household more effectively, though it took her two years to stabilize her finances. She did this by implementing plans she had drawn up much earlier, but hadn't been able consistently to follow. Her problem had not been a failure to understand what she needed to do. It was that she could not consistently do it.
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