Attention Deficit Hyperactivity Disorder (ADHD) is a widespread problem affecting children and adults throughout the United States and many other so-called “first world” countries. It is most commonly discovered before the age of twelve years. Usually it is first noticed by parents or teachers when they find that the child has difficulty concentrating on tasks or when receiving instructions. Until recently, it was separated into two diagnoses: ADD (attention deficit without hyperactivity) and ADHD (attention deficit with hyperactivity). The most recent publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) eliminated the diagnosis of ADD. Nevertheless, it is still broken down to two distinct types of attention deficit. Those who meet the criteria for ADHD without hyperactivity, which is a misnomer in my estimation, have difficulty attending to everyday tasks and projects, are easily distracted, lose focus during conversations and have difficulty following instructions. These are the main criteria for a diagnosis but there are other symptoms which can be problematic for the individual. Frequently, when diagnosed as a child or young adult, medication may be prescribed. There are also strategies used, especially in the classroom, to help the student to regain focus. Another problem area for anyone displaying symptoms of ADHD is social situations. Inability to wait one’s turn when playing a game is one. Getting to an event on time is another. This problem is due to difficulty staying focused on a personal care routine such as showering, brushing teeth, getting dressed and other grooming activities. Parents know that they sometimes have to keep after their children to pay attention to time constraints and remind them to “get moving.” This may carry over into adulthood and make it hard to get out of the house to get to work or to social functions. Many people who were never officially diagnosed learn to accommodate and find ways to stay on track. That does not mean that they are “cured” or have overcome the problem. They are just better at managing it.
Adults with ADHD, even if undiagnosed, often have problems in their relationships. Romantic, sexual or platonic. Friends become frustrated with their lateness, conversational issues and seeming indifference. Romantic partners think that they are disinterested or uncaring. Sexual partners notice that there appears to be a loss of interest at times. Sometimes to the point of losing focus completely!
Because males are more likely to have symptoms associated with ADHD and due to differences in the expression of the issue between males and females, the problem may be more significant. In my practice I’ve discovered that some men who present with difficulty maintaining an erection during sex, also report problems remaining focused during other activities. These men state that they are easily distracted during sex from internal and external sources. They say that a ringing phone, noises from outside the room, verbalizations by their partners and other sounds distract them. They may also be distracted by uninvited thoughts about a myriad of other topics such as work, family or finances. After this occurs on one or more occasions, the thought of it happening again may be the intrusion. Although I am aware that with erectile difficulty not caused by a physical problem this is also quite common, what we call a self-fulfilling prophecy, it seems to be a distinct issue for men with attention deficits.
As with all mental and other medical problems, there is a matter of degree. For some it is relatively mild. But for others it is extreme. And of course often falls somewhere in the middle. Regardless of it’s intensity, it appears to be a contributing factor. I help my patients develop strategies to minimize the effect of these distractions, and those who utilize them regularly, say that they work. As with most treatment strategies, regular practice increases the likelihood that there will be marked improvement.
Small improvements build on each other and there is a steady increase over time. Seeing improvement increases confidence and confident people become confident in their abilities. I remind my patients not to let occasional slides backward discourage them. I assure them that if they have succeeded in the past they can succeed again. Sometimes just knowing that there is a reason for the problem and what that reason is helps them to gain confidence to surmount it. Pay attention, stay focused and get back to basics.