What are the Attention Disorders?

Adults / Children with ADHD or ADD:

There are four (4) types of AD/HD (attention disorder):*

314.01 Attention-Deficit/Hyperactivity Disorder, Combined Type

314.00 Attention-Deficit/Hyperactivity Disorder, Predominately Inattentive Type

314.01 Attention-Deficit/Hyperactivity Disorder, Predominately Hyperactivity / Impulsivity Type

314.9 Attention-Deficit/Hyperactivity Disorder, Not Otherwise Specified

* Please refer to the DSM-5™, (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. 2013) published by the American Psychiatric Assn., Washington D.C. pages 59-to-65.


Related disorders are those which accompany attention impairments. When depression, Dysthymia, bipolar, PTSD, cyclothymia, Aspergers, anxiety, and a number of other disorders coexist with an attention disorder, the term “comorbid” or “concurrent” is used.

Sometimes a disorder is listed as primary and another related disorder associated with the primary disorder is listed as the secondary disorder. Both are addressed and treated separately.

There is much to learn about attention disorders and their related disorders. Becoming educated, engaging in counseling / psychotherapy and benefiting from medical treatment is considered state-of-the-art practice.

The meaning of DUAL DIAGNOSIS

Depressive Disorder (Depression) or milder form of known as Dysthymic Disorder, Bipolar Disorder, (Cyclothmic Disorder, milder form of Bipolar Disorder), and / or anxiety disorders often underlie substance abuse / dependency problems. One of these disorders may accompany substance abuse. When someone is dually diagnosed, the psychological symptoms need to be addressed and treated concurrently with the substance abuse / dependence problems.

ETOH (alcohol0) abuse/dependency and other drug abuse/dependency can induce Bipolar Hypo Mania or even full blown Psychotic Mania, delusions, and visual or auditory hallucinations.

Addiction is a serious disorder which is characteristic of relapse.

The Attention Disorder & Related Disorders Clinic is careful to address both the addiction and the psychological symptoms in dually diagnosed individuals.

Often adults with AD/HD or ADD are battling a substance abuse disorder. This is an example of dual diagnosis. Both conditions are addressed and treated separately.

A very many number of adults with AD/HD also have Post-traumatic Stress Disorder (PTSD) which compounds the AD/HD.


This is a very common myth. The truth is that ADD/ADHD are usually lifelong. Some adults are diagnosed for the very first time when they are in their 20s, 30s, 40s, and even older. The symptoms appeared in childhood, but were under diagnosed and untreated. It is likely that many adults who have come before the justice system or have been incarcerated have underlying ADD/ ADHD and / or related disorders.


Moderate and moderate-to-severe attention disorders and related disorders are real handicaps which affect millions. These disorders impact all aspects of a child’s or adult’s life (physical, social, emotional, psychological, family life, and school / work opportunities). With a correct diagnosis, a carefully constructed treatment plan, and ongoing monitoring, most children and adults can lead a relatively symptom-free life.


ADD – AD/HD is a real medical condition. It is not a fad or a “Yuppie Flu”. ADD or AD/HD has been documented by empirical scientific research studies. In fact, AD/HD (ADD) is the most widely researched disorder in the archives of children’s research literature.

AD/HDers need help in understanding and managing their disorder. With supportive counseling / psychotherapy and medical treatment, lives are completely changed. Yes, believe in ‘rainbows!’


Serious and Sometimes Misdiagnosed Conditions
Which often Coexist or are Related with the following disorders:

  • AD/HD (ADD), Depression, Dysthymia, Anxiety, Mood Swings, Cyclothymia, Bipolar, Asperger’s Syndrome
  • Substance Abuse/Dependency
  • School or Work Adjustment
  • Job Hopping
  • Marital Dysfunctional – Relational Problems
  • Parent – Child Relational Problems
  • Partner Relational Problems
  • Oppositional Behaviors
  • Conduct Problems Involving Justice System
    * American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Fourth Edition. Text Revision. (DSM-IV.TR.™). 2000. Washington DC

Most disorders are characteristic of inattention – loss of focus – selective focusing – procrastination – avoidance – task in completion which complicates the primary disorder – often restlessness and boredom….. ‘related’ disorders’ may be symptoms of AD/HD, Bipolar Disorder, Aspergers, Anxiety (SAD), Depressive Disorders, and Post traumatic Stress Disorder, etc.


AD/HD or (ADD) Symptoms or Characteristics:

Symptom 1: Inattention, distractibility, confusion, disorganization, sloppy, poor penmanship, careless, makes errors, often rushes through

Symptom 2: Inability to complete tasks, doesn’t work up to ability, messy, starts but doesn’t finish feelings of boredom or loneliness, suicidal ideations, broken promises

Symptom 3: Difficulty maintaining relationships, self-centered, oppositionally defiant, argumentative, non-compliant, abuse and infidelity issues, divorce

Symptom 4: Easily bored, seeks novelty, excitement, ‘risk-taker,’ experiments with illegal substances to ‘get high’ or to mask depression or to avoid responsibility

Symptom 5: Frequent errors, accident prone, into ‘trouble’ due to impulsivity, delinquent behavior, court involvement

Symptom 6: Restless, bored easily, always on the go as if driven by a motor, has to move, hyperactive

Symptom 7: Doesn’t listen, interrupts, mind races, thinking of other things, distractible, perseverates, obsesses, blurts out without thinking, rambles, rants and raves

Symptom 8: Issues with rules, boundaries, intrusive, impulsive, superimposing, bold, self-serving, doesn’t accept limits well, lacks self-discipline, does what he/she wants regardless of consequences

Symptom 9: Can’t concentrate but can focus on what is important to him/her (selective focusing), easily distracted, inattentive, focus lability problems [inconsistent, i.e., can sometimes, other times cannot]

Symptom 10: School learning difficulties, school failure, grade retention, referral for special education evaluation, placement in special education [emotionally impaired and/or learning disability programs], vocational / work related problems, job hopping, issues with unemployment

Symptom 11: Jumps from task-to-task, forgetful, does not put away materials, tools, toys, belongings, ruins/damages materials

Symptom 12: Experimental, thrill seeker, likes speed, takes risks, traffic infractions, hangs with irresponsible, social misfits, likes to hang with older crowd, gang involvement

Symptom 13: Broken promises, scams, manipulates, dishonest, cavalier, ‘bites off more than he/she can chew’, expansive, inflated self-esteem, flamboyant, ‘wild and crazy’ behaviors

Symptom 14: Moody, unpredictable behavior, critical of others, blames, anger, rages, overly silly, talkative, pressured speech, rambles on and on, grandiose thinking

Symptom 15: Overspending, gambling, foolish spending patterns, loses money [e.g. left in pockets, careless or unsecured placement of bills]

symptom 16: Insomnia, may go a day or two [sometimes more] without or very little sleep

Symptom 17: Poor driving habits, speeding tickets, moving traffic violations, motor vehicle accidents, DUIs

Symptom 18: Drinks to ‘calm nerves,’ avoid tasks, and/or responsibilities. May develop alcohol abuse or dependency disorder [dual-diagnosis]


Symptoms/Characteristics of Depression & AD/HD (ADD) Can and Do Often Mimic Each Other

Symptom 1: Inattention/ distractibility, confusion, disorganization, feeling tired, anergic [loss of energy], anhedonia [loss of interest in having fun or doing pleasurable things]

Symptom 2: Daydreaming, off in another world, “space cadet,” obsesses, tunes out, i.e., may not be listening

Symptom 3: Problems with organization, may be over focused, overly neat / compulsive which takes too much time, loses track of time, procrastinates, forgets to pay bills, “running behind” and usually late, forgets promises

Symptom 4: Gives-up easily, avoids confrontation, denies problems, makes excuses and promises, unable to meet deadlines, “pie in the sky” ideas, unrealistic, “dreamer”.

symptom 5: Starts but often cannot finish projects, wanders from task to task [often leaving a trail of unfinished projects], makes careless mistakes

symptom 6: Problems with reading comprehension, easily bored, avoid reading, spelling deficiencies

symptom 7: May over focus, reads all of the time and does little else, may lean toward an introvert personality

Symptom 8: Slow to process information, may not process in an entirety, confused, poor at receiving directions

Symptom 9: Forgetful, mind wanders, can’t stay focused, poor assignment completion

Symptom 9: Often isolated, avoidant, sad, lonely

Symptom 10: Slow to finish task, can’t get started

Symptom 11: Hypersomnia, can’t get up and get moving, feels tired, anergic, anhedonia, feeling sad and lonely

Symptom 12: Weight changes: overeating, gaining weight or loss of appetite [anorexia], losing weight

Symptom 13: Indecisive, noncommittal

Symptom 14: Can’t begin tasks, cannot sustain focus, doesn’t finish tasks, disorganized, poor penmanship, works too slowly

Symptom 15: Feels guilty, hypersensivity, suicidal ideation, may have history of rejection and/or abandonment

Symptoms/Characteristics of AD/HD (ADD) with Bipolar Disorder or vice versa:

A child, adolescent, or adult with predominately AD/HD symptoms noted above with Bipolar Disorder features will present with mood instability, mood swings, mood shifts, intensivity, driven emotionality, etc. This category sees overlapping of both disorders. They often manifest manipulative, demanding behaviors with invincibility [no fear of consequences] and impulsivity. Because Bipolars often have their own agendas (self-centered) they are driven to achieve what it is that they want even in an impulsive manner. They also are selective in their focus, i.e., can attend to what interests them but cannot follow what doesn’t, which is a part of the AD/HD. Refer to Bipolar Disorder symptoms and characteristics elsewhere.

Symptoms of Asperger’s Disorder (Syndrome)

  • average or above average intelligence
  • difficulty forming relationships / friendships
  • preference for playing alone
  • plays with older or younger children or prefers adult company
  • ability to verbalize, talks well…often too much or too little
  • poor eye contact
  • sometimes flat affect
  • inability to understand that communication involves listening as well as talking
  • inability to think in abstract ways
  • a literal understanding of what has been said, for example, when asked to ‘get lost’ as in go away, one with AS will become confused and may literally get lost.
  • difficulty understanding the rules of social behavior
  • does not pick up on others’ feelings…not able to ‘read’ body language
  • trouble empathizing
  • behavior can vary from mildly unusual to odd
  • may be aggressive and difficult to control behaviorally
  • has rules of their own…. may engage in rituals and may insist that all family members follow or conform to them
  • shows aggression, anger when things do not go their way
  • difficulty controlling anger
  • manifestations of anxiety
  • sensitivity to criticism
  • repetitive activities (obsession) ritualistic
  • specialized interest, activities, hobbies
  • resists change
  • may have some motor coordination problems
  • some have posture / gait different form peers appearing odd… standing out as different
  • lacks social friends of own age… loner
  • may lack ‘common sense’
  • often has narrow range of interests with strong likes and dislikes
  • anxiety related to low self-esteem is a major hitch hiker onto AS
  • some with AS are very egotistical, arrogant and chauvinistic…

These individuals with Asperger’s Disorder can find their way in life because they are usually highly intelligent and find vocations which match their temperament, personality, sociability, and activity. Many avoid crowds and do not socialize well at parties, family gatherings, and other people-oriented functions. They may be loners. Some are considered odd, strange, different…

(PTST) Posttraumatic Stress Disorder complicates AD/HD

Posttraumatiac Stress Disorder is often diagnosed when major health problems reoccur and result in permanent disability…..

Posttraumatic Stress Disorder is a result of severe neglect, abuse, horrific events, persistent stress, undiagnosed or misdiagnosed mental health issues..


        “…it was the best of times; it was the worst of time..”

by Charles Dickens (A TALE OF TWO CITIES)

Life can get better…BELIEVE


Children may be overdisciplined, sometimes severely and cruelly.  Rejection by teachers, school personnel, and peers is common, such children are often the family scapegoat or bullied by peers.

  • Inability to listen to directions and follow them
  • Unfinished tasks
  • Forgetful
  • Out-of-seat, wandering
  • Restlessness, fidgety
  • Difficulty follow directions especially oral directions
  • Problems with boundaries
  • Not accepting limits
  • Disruptive behavior
  • Poor memory
  • Distractibility, inattentiveness
  • Inability to sustain focus on tasks
  • Sloppy work, messy desk, disorganized
  • Messy desk and surroundings
  • Low or poor grades
  • Grade retention
  • Special education placement
  • School suspension
  • Early dropping out


Social problems occur, and some are:

  • Adjustmental difficulty
  • Impulsivity, poor listening skills
  • Anger control problems
  • Intrusiveness
  • Smoking, other drug experimentation
  • Risky behaviors, seeks thrills, excitement
  • Boredom, pursues new and novel activities
  • Indulges in early sexual activity
  • Juvenile delinquency
  • Manipulativeness, incorrigibility
  • Stays out past curfew, runs away from home
  • Seeks out other ADDers – AD/HDers
  • Hangs out with social misfits (often older)
  • Joins cults / gangs
  • Early pregnancy
  • Drug abuse / dependency / police involvement
  • Reckless driving, speeding tickets, other traffic violations
  • Prone to accidents / DUIs / motor vehicle accidents
  • Poor job skills, job hops
  • Minimum wages, unemployment
  • Welfare recipient
  • Relationship problems, divorce
  • Family violence: child / partner abuse
  • Accidental death, suicide

All of the above cost taxpayers billions of dollars to maintain safety for citizens and to provide rehabilitative services for the offenders. There has been an increase in the numbers of individuals sentenced to jail / prison time. More jails and prisons are being constructed. More probation officers are being hired. Substance abuse / dependency / rehabilitative centers have a high recidivism rate; that is, the probability of relapse is very high: 85 to 90 percent. Substance abuse / dependency should be considered “diseases of relapse”. These services are not only costly but heartbreaking to families. Where children are involved, a poor example is often being modeled. This is why many of the attention disorders and related disorders seem to run in families, in which the same disorders or related disorders can be traced back (genograms) to previous generations.



A genogram is a diagram constructed in therapy to depict family relationships extended over at least three generations. In the diagram, critical events, such as death, divorce, remarriage, alcoholism, mental illness, etc., reveal recurring patterns of behavior which help to determine how behaviors or psychological problems are handed down from generation to generation.

Many disorders are inherited. Often never diagnosed but characteristic of poor social adjustment, social ‘misfit’ lifestyle, alcohol (ETOH) abuse/dependency, child abuse, spouse abuse (violent outbreaks) (rages, raging), unemployment, jail… prison….  There was an underlying diagnosis which was never identified and never treated…


The Attention & Related Disorders Clinic offers counseling / psychotherapy for adults, adolescents, and children, including preschool-aged children who are depressed, mood-disordered, oppositional defiant, ADHD, hyperactive, timid, fearful, or otherwise troubled.


In this day and age, you cannot afford not to get help….seek to find out what is going on, what is the diagnosis and what is the treatment!!!!

Here at The Attention Disorder & Related Disorders Clinic practically everyone and anybody can get an appointment (I even work with you online via email) I have over 65 insurance companies, do sliding scale to reduce costs to fit your income level and even do some pro bono services to especially help children who are failing in school

Sometimes one has to say “You cannot afford NOT to get help”.  Dr. Hughes’ concern is that many individuals go without services because clinician’s fees are not affordable. The Attention Disorder & Related Disorder Clinic aims to set fees and to provide quality service which are realistic and affordable.

Individuals who go without treatment are at heightened risk because they may develop additional problems which “piggy-back” on to existing problems and in time usually worsen.

Attention and related disorders interfere with school / work success and cause severe relationship problems. These problems are often neurobiochemical (caused by brain deregulation or imbalance) and can be corrected. Usually counseling / psychotherapy is advised to complement any medical treatment. One without the other is like a cart without the horse!


Absolutely! Moderate and moderate-to-severe attention disorder and related disorders are real impairments (handicaps) which affect millions. These disorders impact on all aspects of a child or adult’s life (physical, social, family, emotional, psychological) and school / work opportunities. With proper diagnosis and a carefully designed treatment plan, most children and adults can lead a relatively symptom-free life. “There is hope at the end of a rainbow!”


The Attention Disorder & Related Disorders Clinic offers creative, supportive counseling and psychotherapy to individuals of all ages with attention and / or related disorders by helping them to develop awareness of what these disorders are, an understanding of how the brain is involved (not your fault), knowledge of the mysteries of medication, time management, behavioral management, cognitive thinking, conflict resolution and stress management.


Yes, that is partly true. One day you discover that you are unhappy and that life “sucks”! You’ve even thought that you would like to end your life! Waking up to the causes helps you to take responsibility for dealing with a disorder which lands you in predicaments that give you second thoughts about how you are living your life. You try to change by yourself and find that you can’t! It’s like having myopia (near-sightedness) where you must wear a corrective lens to see at a distance. Driving without wearing your corrective lens makes you highly-at-risk for injuring yourself and others. After the fact, you cannot say that you forgot your lenses or that you didn’t think you needed them! (denial is big!).

Once you are diagnosed with an emotional / mental / behavioral disorder, it becomes your responsibility to be in control. Medication is a huge help when it is complementary to your system, but a lot of the real work to improve your life is up to you!

The Attention Disorder & Related Disorder Clinic

This clinic pledges an attempt to ensure that you receive reinforcement (strength) through regular counseling / psychotherapy sessions – that you can develop new energy to think differently.

Learning new ways to cope with problems, taking well-thought-out steps to recovery, reduction of stress, increased self-esteem, self-empowerment, independence, and self-confidence are a few examples of what the Clinic’s objectives will be for you. In some ways, you will be developing a “new you,” a “happier you”.  You will begin to believe in “rainbows”  and develop self-esteem, self-confidence, and self-competency in order to live a meaningful and happier life.


In addition to her qualifications and many years of experience, Dr. Hughes believes in using empirical, normal evaluative instruments which closely depict and support her diagnosis. A considerable amount of research has been accumulated to arrive at a comprehensive evaluation. Depression and moods such as bipolar (manic depressive) disorder and ADD – AD/HD are serious and often misdiagnosed or underdiagnosed conditions, which require specific consideration and efficacious treatment. The Attention Disorder & Related Disorders Clinic pledges to make a difference, and will accept individuals who otherwise could not afford psychological / mental health services.

ADD – AD/HD Comorbid Anxiety

Recent research from NIMH (National Institute for Mental Health) indicates that it is important to assess for the presence of comorbid anxiety and negative affectivity. It is important to assess for coexisting anxiety, depression, oppositional defiant, and conduct disorders. This is going to be found more often with adults, teens, and children who exhibit the hyperactivity and impulsivity type of attention disorders. They are likely to have poor social skills.

 WHAT IS CH.A.D.D. ???? 

CH.A.D.D. stands for Children and Adults with Attention Deficit Disorders.It is a wonderful organization! and is Florida-based. A support organization for ADDers, AD/HDers, parents, significant others, teachers, school personnel, and mental health professionals; you may be able to benefit from their extensive networking. CH.A.D.D. is nationwide, with local groups in all states. The Fort Myers Chapter meets regularly at Lee Memorial Hospital, and their website is: www.CHADD.com It is a highly influential organization which has been instrumental in making America wake up to ADD / ADHD.


The Attention Disorder & Related Disorders Clinic addresses the following disorders: 

  • Anxiety disorders
  • Panic disorder and agoraphobia
  • Obsessive-compulsive disorder
  • School phobia (school refusal)
  • Separation anxiety
  • Social phobia
  • Selective mutism
  • ADD, AD/HD
  • Asperger’s Disorder/Syndrome
  • Tourette syndrome, disruptive behavioral disorder
  • Early onset pediatric Bipolar Disorder
  • Bipolar Disorders
  • Borderline Personality Disorder
  • Dysthymia
  • Cyclothymia
  • Anger management problems
  • Oppositional defiant disorder (ODD)
  • Conduct disorder (CD)
  • Problems involving juvenile justice system
  • Involvement with the criminal justice system, court related problems
  • Custody evaluations
  • Family violence
  • Spousal abuse
  • Depression, dysthymia
  • (manic depressive) now know as Bipolar Disorder (Cyclothymia – mild form)
  • Mood disorder
  • Personality disorders
  • Relationship problems
  • Partner relationship dysfunction
  • Marital difficulties
  • Family dysfunctions
  • Post-Traumatic stress disorder (PTSD)
  • Developmental delays
  • Developmental disorders
  • Learning disabilities
  • School adjustment problems
  • Dementiabullet Alzheimer’s disease
  • Schizophrenia (follow up / maintenance follow through / counseling
  • Schizoaffective disorder
  • Follow up / maintenance counseling)
  • Substance abuse
  • Substance dependency
  • Alcohol (ETOH) abuse/dependency
  • Drug abuse/dependency/addiction