Recognizing and Managing ADHD

Time management can be our friend or our nemesis – how we use time, and our ability to stay organized and on task varies from person to person. We may be constantly drawn in several directions simultaneously, often with multiple conflicting priorities. For many task-oriented people, variety is the spice of life and they thrive on challenges and deadlines. But for others, it’s often difficult to remain focused, to complete tasks without interruption or distraction, or to finish one assignment or activity before moving onto something else.

The failure to remain focused, difficulty completing tasks without interruption, and the inability to successfully negotiate distractions can be signs of chemical, emotional, and genetic challenges such as Attention Deficit Disorder (ADD), or Attention Deficit Hyperactivity Disorder (ADHD).

Over the past decades, these symptoms have been more readily diagnosed in children, especially those having trouble in school or unable to relax, play quietly or get along effectively with others. With today’s technological advances, it’s easy to blame over-stimulation for playing a strong supporting role in keeping kids off balance, more easily bored without technology, and wanting more all the time. But for adults, these same symptoms can be more insidious, limiting our efficiency at work and at home, straining relationships, and interfering with sleep and health.

Currently, approximately seven percent of American children are being treated with medications for ADHD, and about half of them will carry those symptoms into adulthood, says the American Psychiatric Association. The Centers for Disease Control and Prevention (CDC) estimates numbers are even higher, at least twice as many. On top of that, many adults have ADHD or ADD but have never been diagnosed.

The average age of ADHD diagnosis is seven years old. Males are almost three times more likely to be diagnosed with ADHD than females, and during their lifetimes, 13 percent of men will be diagnosed with ADHD. Just 4.2 percent of women will be diagnosed.

Signs You Might Have ADD or ADHD

Symptoms of ADHD typically first appear between the ages of three and six, but as many children and adults have never been diagnosed, it’s difficult to judge exactly when symptoms might have appeared, since those inflicted have been living with these challenges most of their lives. Here are common behavioral signs:

  • Lack of focus.Possibly the most telltale sign of ADHD, “lack of focus,” goes beyond difficulty paying attention. It means being easily distracted, finding it hard to listen to others in a conversation, overlooking details, and not completing tasks or projects.
  • Hyperfocus. While people with ADHD are often easily distracted, the flip side of the coin is called hyperfocus. A person with ADHD can be so engrossed in something that they can ignore anything else around them. This kind of focus makes it easier to lose track of time, ignore those around you, and cause relationship misunderstandings.
  • We all forget things occasionally. But for someone with ADHD or ADD, forgetfulness is an everyday part of life. This includes routinely forgetting where you’ve put something or important dates. Some can be menial. Others can be serious. The bottom line is that forgetfulness can be damaging to careers and relationships because it can be confused with carelessness, lack of intelligence, or ambivalence.
  • Impulsivity. Impulsiveness in someone with ADHD or ADD can manifest in several ways:
    • Interrupting others during conversation
    • Being socially inappropriate
    • Rushing through tasks
    • Acting without much consideration to the consequences

Even a person’s shopping habits are often a good indication of ADHD. Impulse buying, especially on items they can’t afford, is a common symptom of adult ADHD.

  • Restlessness and anxiety. As an adult with ADHD, you may feel like your engine never stops. Our yearning to keep moving and doing things constantly can lead to frustration when we can’t do something immediately. This leads to restlessness, which can lead to frustrations and anxiety. Anxiety is a very common symptom of adult ADHD, as the mind tends to replay worrisome events repeatedly.
  • Poor health. Impulsivity, lack of motivation, emotional problems, and disorganization can lead a person with ADHD or ADD to neglect their health. This can be seen through compulsive poor eating, neglecting exercise, or forgoing important medication. Anxiety and stress negatively affect health, so without good habits, the negative effects of these illnesses can make other symptoms worse.
  • Relationship issues. An adult with ADHD or ADD often has trouble in relationships, whether they are professional, romantic, or platonic. The traits of talking over people in conversation, inattentiveness, and easily being bored can be draining on relationships as a person can come across as insensitive, irresponsible, or uncaring.

Treatment and Coping with ADHD

People who experience some or many of these symptoms also change employers more often, miss deadlines, experience higher use of alcohol, tobacco and drugs, and suffer from repeated relationship failures, including divorce. If all of this sounds too familiar, it doesn’t mean you suffer from adult ADD or ADHD. But if you do, here are a few steps you can take to improve your life.

Treatment for adult ADHD or ADD is similar to treatment for childhood ADHD/ADD, and includes stimulant drugs or other medications, psychological counseling (psychotherapy), and treatment for any mental health conditions that occur along with adult ADHD.

Stimulants (psychostimulants) are the most commonly prescribed medications for ADHD, but other drugs may be prescribed. Stimulant drugs are available in short-acting and long-acting forms. Other medications used to treat ADHD include antidepressants. The right medication and the right dose vary between individuals, so it may take some time in the beginning to find what’s right for you. Talk with your doctor about the benefits and risks of medications. And keep your doctor informed of any side effects you may have when taking your medication.

Counseling for adult ADHD can be beneficial and generally includes psychological counseling (psychotherapy) and education about the disorder. The benefits of psychotherapy can include:

  • Improve time management and organizational skills
  • Learn how to reduce impulsive behavior
  • Develop better problem-solving skills
  • Cope with past academic and social failures
  • Improve self-esteem
  • Learn ways to improve relationships with family, co-workers and friends
  • Develop strategies for controlling temper, stress and impatience

ADHD is a neuropsychiatric condition that is typically genetically transmitted. These challenges are caused by biology, essentially a miscue in how our brain is wired. It is not a disease of the will, a moral failing or weakness in character. Professional interventions, medication, support groups and self-education can help those with ADHD manage, or even overcome many of these challenges.


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Feel the Burn… Heartburn, That Is

Millions of Americans suffer from heartburn and digestive discomfort, typically caused by excess stomach acid and related complications. But being in good company is small comfort when you’re uncomfortable or miserable. However, there are steps you can take to mitigate acid-related issues, and it’s important to pay attention to warning signs before untended stomach problems lead to more serious health issues.

Gastroesophageal reflux disease (GERD) is a chronic digestive disease. GERD occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe (esophagus). The backwash (reflux) irritates the lining of your esophagus and causes GERD.

Both acid reflux and heartburn are common digestive conditions that afflict many people periodically. When these signs and symptoms occur regularly or interfere with your daily life, or when your doctor can see damage to your esophagus, you may be diagnosed with GERD.

What is GERD?

When we swallow, the lower esophageal sphincter — a circular band of muscle around the bottom part of our esophagus — relaxes to allow food and liquid to flow down into our stomach. Then it closes again.

However, if this valve relaxes abnormally or weakens, stomach acid can flow back up into our esophagus, causing frequent heartburn.

This constant backwash of acid can irritate the lining of our esophagus, causing it to become inflamed (esophagitis). Over time, the inflammation can wear away the esophageal lining, causing complications such as bleeding, esophageal narrowing or Barrett’s esophagus (a pre-cancerous condition).

GERD signs and symptoms include:

  • A burning sensation in the chest (heartburn), sometimes spreading to the throat, along with a sour taste in the mouth
  • Chest pain
  • Difficulty swallowing
  • Dry cough
  • Hoarseness or sore throat
  • Regurgitation of food or sour liquid (acid reflux)
  • Sensation of a lump in the throat

Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications, or even surgery, to reduce symptoms. Conditions that can increase risk of GERD include obesity, pregnancy, smoking, asthma, diabetes, regular constipation, and poor diet.

Over time, chronic inflammation in our esophagus can lead to complications, including narrowing of the esophagus (esophageal stricture), which can lead to the formation of scar tissue, narrowing the food pathway and causing difficulty swallowing. Another typical complication is the forming of an open sore in the esophagus (esophageal ulcer). This may cause bleeding, pain and make swallowing difficult.

Also, hiatal hernias, which are an opening between the stomach and the esophagus, can occur. If untreated, this can lead to pre-cancerous changes to the esophagus (Barrett’s esophagus). With this condition, the tissue lining the lower esophagus changes. These changes are associated with an increased risk of esophageal cancer; doctors will likely recommend regular endoscopy exams to look for early warning signs.

Managing and Reducing Acid Reflux

Lifestyle changes may help reduce the frequency of heartburn. Here are several helpful and simple steps to consider:

  • Maintain a healthy weight.Excess weight puts pressure on our abdomen, pushing up our stomach and causing acid to back up into our esophagus. If you are overweight or obese, work to slowly lose weight — no more than one or two pounds a week.
  • Avoid tight-fitting clothing.Clothes that fit tightly around our waist put pressure on our abdomen and the lower esophageal sphincter.
  • Avoid foods and drinks that trigger heartburn. Common triggers such as fatty or fried foods, tomatoes, alcohol, chocolate, mint, garlic, onion, and caffeine may make heartburn worse.
  • Eat smaller meals.Avoid overeating by eating smaller meals.
  • Don’t lie down after a meal.Wait at least three hours after eating before lying down or going to bed.
  • Elevate the head of your bed.If you regularly experience heartburn at night or while trying to sleep, raise the pillow end of your bed by six to nine inches (can use wood or cement blocks). Or insert a wedge between your mattress and box spring to elevate your body from the waist up. Wedges are available at drugstores and medical supply stores. Raising your head with additional pillows is not effective.
  • Don’t smoke.Smoking decreases the lower esophageal sphincter’s ability to function properly.

Treatment for heartburn and other signs and symptoms of GERD usually begins with over-the-counter medications that control acid. If you don’t experience relief within a few weeks, your doctor may recommend other treatments, including medications and surgery.

There are a variety of stronger, prescription medications for managing GERD. Contact your doctor before taking any new medications or if symptoms are not relieved. Also, seek immediate medical attention if you experience chest pain, especially if you have other signs and symptoms, such as shortness of breath or jaw or arm pain. These may be signs and symptoms of a heart attack.


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Eat This Pumpkin, Pumpkin!

The fresh autumn harvest offers a bounty of delicious and heart-healthy fresh fruit and vegetables. Apples, pears, broccoli and Brussels sprouts are fresh from the garden or farm this time of year, and represent only a few of the many nutritionally rich seasonal foods that can help us feel better and stay healthier. And if delicious isn’t enough of an incentive, many of these items have properties that help protect against maladies like heart disease and stroke.

The fall palette includes deep colors like oranges, reds, and purples. Especially prominent in the cooler months, these colorful alternatives like pumpkins, beets, cranberries and squash are readily available, tasty and nutritional masterpieces. Fruits and vegetables with color contain vitamins, minerals, fiber and phytochemicals that have different disease-fighting elements. These compounds may be important in reducing the risk of many conditions, including cardiovascular disease. The American Heart Association recommends at least four to five servings per day of fruits and vegetables based on a 2,000-calorie diet as part of a healthy lifestyle that can lower our risk for many diseases.

As the season changes, the shorter, cooler days make it harder to get physical activity outdoors. And there are the calorie-packed temptations of post-season baseball gatherings, football parties, Halloween sweets and, before you know it, Thanksgiving buffets. So a good way to avoid those extra seasonal pounds is to keep eating plenty of fresh fruit and vegetables.

Seasonal Favorites are Loaded with Nutrients

Purchasing produce at its peak guarantees the freshest taste, the greatest nutritional value and the most affordable price. Apples and pumpkins are two popular foods celebrated this time of year, but there’s also an abundance of delicious and hearty greens like kohlrabi, collards, chard, lettuce, cabbage and spinach, as well as colorful carrots, sweet potatoes, peppers, green onions and a variety of squash to enjoy. Eating according to the seasons also is better for the environment — seasonal food, especially when purchased locally, requires fewer resources to grow, store, and transport.

Here’s some guidance on the best choices to make for a healthy, fresh fall diet:

  • Pumpkins: The bright orange color of pumpkin is a dead giveaway that it is loaded with an important antioxidant, beta-carotene. Beta-carotene is one of the plant carotenoids converted to vitamin A in the body. In the conversion to vitamin A, beta carotene performs many important functions in overall health. Research indicates that a diet rich in foods containing beta-carotene may reduce the risk of developing certain types of cancer and offers protection against heart disease. Beta-carotene offers protection against other diseases as well and reduces some degenerative aspects of aging. There are dozens of great, easy recipes online for using pumpkins as side dishes, soups and breads, or for integrating it into salads, desserts, and much more.
  • Apples: These red and green gemsare a perennial favorite. Though available year-round, they are especially crisp and flavorful when the newly harvested crop hits the market and farm stands. Ranging in flavor from sweet to tart, locally grown apples are at their peak from September through November. There are over 100 varieties grown in the United States, and every state, including Connecticut, has multiple orchards, so an apple-picking outing is usually within convenient reach.

Apples are delicious, easy to carry for snacking, low in calories, a natural mouth freshener, inexpensive, and a source of both soluble and insoluble fiber. Soluble fiber such as pectin actually helps to prevent cholesterol buildup in the lining of blood vessel walls, reducing the incident of atherosclerosis and heart disease. The insoluble fiber in apples provides bulk in the intestinal tract, holding water to cleanse and move food quickly through the digestive system.

It’s a good idea to eat apples with their skin. Almost half of the vitamin C content is just underneath the skin. Eating the skin also increases insoluble fiber content. Most of an apple’s fragrance cells are concentrated in the skin and as they ripen, the skin cells develop more aroma and flavor.

  • Sweet potatoesare a healthy complement to any meal. They are rich in carotene, a precursor to vitamin A, and supply about twice the recommended daily amount of vitamin A. They are also a good source of dietary fiber, potassium and vitamin C. One medium baked sweet potato has only 103 calories.
  • Beetsare another healthy seasonal favorite, though not as popular. Beets are low in calories and fat, cholesterol free, and a good source of folates, a B vitamin which supports red blood cell production and helps prevent anemia. Fresh beets, in season from late summer through October, have a sweet flavor and tender texture. While traditionally a garnet-red color, beets also are available in golden-yellow, white and red-and-white-striped hues, and are a terrific addition to salads, casseroles and simply roasted.
  • Brussels sprouts:Closely related to cabbage and broccoli, Brussel sprouts have a similar look and taste. Peak season is September through February.
  • Chicories: Another healthy choice includes chicories. Belgian endive, escarole and radicchio are all chicories. They are related to lettuces, but have sturdier leaves, a stronger flavor and are known for a slightly bitter taste. They’re typically harvested in late fall and early winter.  In addition, endive and radicchio can be used to perk up any bagged salad, and escarole soup is a classic. For something different, sauté escarole in olive oil with garlic and red pepper, just like you would sauté spinach. The greens won’t cook down as much and can stand up to the heat.
  • Seasonal squash: Butternut and Acorn Squash are hearty and healthy.Covered in a thick rind, these winter squashes are the ultimate storage vegetable. Harvested in early fall and throughout the winter months, roasted squash complements many recipes, are a welcome addition to roasted meats, and make delicious soups and side dishes.

The autumn is a wonderful time of year to eat, recreate and prepare our bodies for the colder months that follow. Enjoy its abundance, indoors and out, and have a colorful fall outdoors and in your kitchen!


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Why Health Illiteracy Could Be Making Employees Sick

How well do you listen to your doctor’s directions or orders regarding medications, exercise, diet and other health-compliance issues? When you go for a test, do you understand what’s being done and why? Are you aware of recommended preventive-care measures you should be practicing? Do you recognize signs and symptoms of potentially serious illnesses early enough to intervene, or wait until your health deteriorates enough to justify calling a medical professional?

If you recognize yourself in any of these queries, you are among the 88 percent of American adults with health literacy challenges. And when you stop to consider that nine out of 10 adults may lack the skills to manage their health and prevent disease – and apply that consideration to your workforce – the impact of that lack of knowledge should make you feel sick!

The Department of Health and Human Services defines health literacy as “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.” Nearly 90 million Americans have difficulty understanding and using the information shared by their doctor, clinic or hospital. A high degree of reading literacy does not necessarily translate into a high degree of health literacy, nor does a college education.

Poor health literacy affects individuals of many different ages, languages, cultures and education levels. For example, someone may question if he can drink coffee before a fasting lab test, forget how and when to take newly prescribed medication, or decide to stop taking medication when she is feeling better. And it can be difficult for anyone, regardless of their reading literacy skills, to remember instructions or read a medication label when feeling sick.

Only 12 percent of adults have proficient health literacy, according to the National Assessment of Adult Literacy. Furthermore, 14 percent of adults (30 million people) have below-basic health literacy. In studies, these adults were more likely to report their health as poor (42 percent). Additionally, there is a mismatch between the reading level of health information and the reading skills of the public. There also is a mismatch between the communication skills of lay people and health professionals.

Without clear information and an understanding of the information’s importance, people are more likely to skip necessary medical tests, end up in the emergency room more often, and have a harder time managing chronic diseases like diabetes or high blood pressure. As reported by the U.S. Department of Health and Human Services, individuals with limited or low health literacy

  • Skip preventive care
  • Are more likely to have chronic conditions and less able to manage the conditions
  • Have more preventable hospital visits and admissions, with longer stays
  • Are more likely to use medications inappropriately or ineffectively
  • Are often ashamed to ask for help making health care decisions.

Improving Health Literacy in the Workplace

For employers, the relationship of low health literacy to poor health behaviors results in overall higher costs of drug, medical and disability claims, lower productivity and higher absenteeism. Employers can have a significant positive impact on the health literacy of their employees and, ultimately, influence better health and financial outcomes. Here are recommended steps to improve health literacy in the workplace:

  • Use clear and simple messaging. Keep it simple. Clearly state the actions you want your employee to take, and discuss options and potential consequences.
  • Get rid of complex jargon.Insurance and medical industry professionals throw around a lot of jargon. Ask your insurance provider and benefits consultant to include descriptions of benefits and how to use the benefits in consistent, easy-to-understand language. This includes their member website or portal, Explanation of Benefits (EOB), emails, and mailers.
  • Treat everyone the same.No matter their job title, assume all employees may have difficulty understanding health, wellness and benefits communications. Use simple, easy-to-understand language.
  • Empower employees to take charge of their health.When people take an active role in their healthcare, research shows they fare better in both health and financial outcomes. Increase employee confidence in their ability to advocate for themselves by providing educational materials and holding workshops. Topics could include how to talk to a doctor, how to get more support when you need it, and how to ask questions about insurance coverage.
  • Identify a navigator.Consider a current staff member or external support person who can help employees navigate the complex world of benefits available.
  • Technology isn’t for everyone. Don’t leave behind those who aren’t as comfortable or familiar with technology. Depending on the range of ages and skills in your workforce, use a variety of communication methods to share health and wellness information. This includes emails, texts, and verbal updates at team meetings.
  • Repeat information regularly.Don’t expect your once-a-year open enrollment presentation to be memorable enough that your employees remember their benefits. Plan year-round campaigns and communications using frequent but brief messages, and talk with employees about their role in managing their health.
  • Remember the household decision makers. While you may give employees a lot of information while they are at work, the person making decisions about when and where to go for healthcare may not be getting that same information translated to them. Consider home mailings, invitations to open-enrollment meetings, and other ways to ensure all family members on the medical plan receive credible sources of health and wellness information.

The benefits of health literacy improvement include enhanced communication, greater adherence to treatment, increased ability to engage in self-care, and overall improved health status. Healthier employees result in a healthier workplace, and we can all feel good about that.


If you’re not enjoying the benefits of a wellness program at your company, join CBIA Healthy Connections at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!