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Section 6
Depression

Question 6 | Test | Table of Contents

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In the last section, we discussed the ADHD adult’s passive and aggressive methods of coping. The passive methods of coping for an ADHD adult were the "Who Cares?" attitude and the "Take Me or Leave Me" attitude. The aggressive methods of coping for an ADHD adult were Rebellion and Perfectionism.

In this section, we will discuss the Five Stages of Grief. As you are well aware, these five stages are Anger, Denial, Bargaining, Depression, and Acceptance. Obviously, when ADHD adults first receive their diagnosis, they often have to go through these five stages. Let’s look at how Stacy has worked her way through the five stages of grief. As I describe these to you, think of what stage your current ADHD client is in.

5 Stages of Grief

♦ Stage # 1 - Anger
Stacy, age 34, has been a stay-at-home mom for several years. She manages a household with three hyperactive disobedient boys. A few years ago, Stacy was diagnosed with ADHD. When she first found out about her diagnosis, Stacy experienced the first stage of grief, Anger.

She stated, "I was just so mad at first. For years I was misunderstood. Nobody believed I really was trying my hardest, and they always yelled at me when my best wasn’t good enough. I always knew something was wrong, but nobody believed me! I finally understand why everything has always been such a struggle for me, but now I’m pissed! I mean, I’m imperfect, I’m not like everyone else, and it’s just not fair!"

After Stacy got over her initial anger, she went through the motions of coping with the diagnosis. She decided to try medication, and was given a prescription for Ritalin. After a couple of weeks, Stacy stopped taking the Ritalin because it was giving her insomnia. However, she neglected to inform her doctor of the decision to stop taking it. Stacy went back to life as it was before her diagnosis.

♦ Stage # 2 - Denial
Stacy stated, "I had kind of gotten it figured out before they diagnosed me. Sure, my house was a little crazy, and I had difficulties managing my kids’ behavior sometimes, but that was how I was used to it!" As you can see, Stacy had entered the second stage of grief, Denial. She didn’t find comfort in the diagnosis even though she had for years known that "something was wrong."

Stacy fell back into her old habits of attributing the confusion of her life to external factors. Remember Adam from section 4, who coped with his ADHD through the controlling method of blaming? Like Adam, Stacy would not take the blame for any of the confusion in her life. However, unlike Adam, Stacy did not blame other people, but rather situations and uncontrollable events.

♦ Stage # 3 - Bargaining
Stacy went for a couple of months without medication, but realized she still couldn’t handle her life as evidenced by her inability to manage her children’s behavior to keep the house organized enough to do the laundry and buy the right groceries. Following Stacy’s realization that she was unable to manage her life without admitting that she had ADHD, she met with her doctor again to discuss other medication options. Stacy admitted to her doctor that the original prescription of Ritalin had caused insomnia, and he offered to help her try different prescriptions.Stacy agreed.

She stated, "I figure if we just find the right one, everything will be OK. I’ll keep trying different drugs until I find the one that makes me normal. Then I’ll be all right, I’ll be like everyone else." Sound like something a client of yours has said? As you can see, Stacy had worked her way to Bargaining, the third stage of the five stages of grief.

♦ Stage # 4 - Depression
Unfortunately, even with medication, Stacy reluctantly realized she wasn’t entirely cured. Stacy stated, "Now that I can pay more attention, I realize how many mistakes I make. Besides that, at the end of the day, the drug’s usually not even working as well anymore. I’m still not normal!" This realization sent Stacy slipping into the fourth stage of grief, Depression. Stacy stated, "I feel like I’m doomed. I constantly burst into tears, even over stupid comments or innocent remarks." As you know, if an ADHD adult remains depressed, their progress may be undermined. Which ADHD clients are you currently treating who are in the depression stage?

♦ Stage # 5 - Acceptance
Before Stacy could proceed to the fifth stage of grief, Acceptance, I realized she would have to overcome her depression. To help her make progress overcoming the depression, I suggested an exercise I call "Adding Up Blessings." See if this obvious technique is one that you may have overlooked in working with a current client.

"Adding Up Blessings" Exercise - Four Steps
To do the four steps of the "Adding Up Blessings" exercise:
-- Step One - I first asked Stacy to make a mental inventory of the blessings in her life. I handed her a notebook and stated, "Go ahead and write them down, so you don’t forget any."
-- Step Two - For the second step, I had her make another list. I stated, "In this second list, put down all the horrible things you can imagine that you don’t have, or that have never happened to you."
-- Step Three - In the third step, I asked her to put these lists somewhere that she would see them regularly, such as on the refrigerator door or a wall in her home. Stacy stated, "I think maybe I’ll tape them to my bathroom mirror."
-- Step Four - Finally, for the fourth step, I explained that she could read these lists whenever she felt herself sinking into a negative mindset. I stated, "Reading these lists can work as a quick pick-me-up."

Do you have an ADHD client who is working through the Five Stages of Grief? Is he or she, like Stacy, stuck in any of the stages, such as depression? If so, would your Stacy benefit from the "Adding Up Blessings" exercise?

In this section, we have discussed the Five Stages of Grief that the ADHD adult experiences following diagnosis. The Five Stages of Grief were Anger, Denial, Bargaining, Depression, and Acceptance.

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