"Do something!" the distraught mother yelled as her child, who had been hit by a car, lay in the road. Jack heard the screams, jumped over the fence in his backyard, and ran to the accident. He dialed 911 on his cell phone while his free hand ripped his T-shirt off. Kneeling next to the child, he handed his phone to someone else, and used his shirt to make a tourniquet on the child's bloody arm.

"My brain became laser-focused," Jack told a reporter. "I don't remember hurtling the fence or making the 911 call or anything. I just did what had to be done."

Jack is not known for his decisiveness. An adult with ADHD, his train of thought often jumps the track, re-routes, or misses the station altogether. In her book, The Gift of Adult ADD, author Lara Honos-Webb, Ph.D., observes that ADD adults, "…being grounded in the present, can often be counted on to make quick, on-the-ground decisions in the heat of the moment without a lot of information synthesis, because they think like firefighters."

Some Like It Hot

ADDers are often great at making "hot decisions" at urgent moments. Fast-moving events light up the neurotransmitters of the ADD brain and focus attention. But what about "cold decisions"? Not so much. Cold decisions require you to make up your mind. It's a thoughtful process, in which you reach a conclusion by using the brain's executive functions (EF). EFs are like the scaffolding alongside a building that is under construction. The scaffolding supports workers, tools, supplies, and all sorts of activity necessary to construct the building. EFs support decision-making. Many ADDers have a problem tapping into their EFs.

Many cold decisions are information-driven, and ADHDers find it difficult to screen out irrelevant information. They are turned on by new information and the thrill of the hunt for more of it. In the era of endless information we live in, this behavior goes rampant. The EF scaffolding can't hold up. Throw in the ADD tendency toward low-frustration tolerance, and it's easy to understand why making up the ADD mind is either 1) a "getting it over with" relief from indecision, or 2) giving in to a passive default decision to relieve the angst.

I see this in my organizing business. Marsha and I were clearing out her closet. She tucks a belt under her left armpit, dangles a handbag from her right arm, puts a scarf in her left hand, and clutches a purse in her right hand. Each item represents a low-consequence decision she can't make about whether to keep the item or give it away. Marsha's default decision? Keep them all.

Brittany has to make a higher-consequence decision. She needs to choose a 401(k) plan among different options. "There is just too much information, and I never seem to be able to decide in time," Brittany says. So she's stuck with a default 401(k) plan.

You don't have to make decisions this way. You can make sounder decisions more promptly. Here are some practical tools for being more decisive.

Next: Decisions Big and Small

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