Many Children With ADHD Continues Into Adults With ADHD
Question: Six months ago, our ten-year-old son was diagnosed with Attention Deficit Disorder (ADD). At the beginning, we were reluctant to give him medication. After a few weeks of treatment, we couldn’t believe in his improvement. Instead of arguing constantly, he has become much more polite, and received the honour of “most improved student” in his class. After learning more about this condition, my wife said that I also have ADD. I have to admit that she is probably right. I did all the “bad” things my son used to do when I was growing up. Even now I have problem organizing and paying attention, and my impulsive spending almost ruined our family. Is it possible that I have ADD, and it is still affecting me? Where can I find out and get help?
For a long time, many people believe that ADD only exists in children, and they “outgrow” the problem when they get older. It is only in the last two decades that some specialists started to recognize that ADD continues into adulthood, although the symptoms can be quite different.
Before going on any further, I should mention that I grew up in a family with ADD. I have a brother who has severe hyperactivity. He misbehaved all the time, and had received a lot of physical punishment from my father, who didn’t know what else to do to make him behave. I have two other brothers who were not hyperactive, but had great deal of difficulty paying attention. As a result, they dropped out of school at a very young age. All of them are still affected, to some degree, by the problem of ADD.
The most recognizable symptom of ADD is probably hyperactivity. In school-aged children, those with ADD and hyperactivity tend to stand out in their class. They have difficulty sitting still, and their body can be in constant motion.
When these children become teenagers, their hyperactivity often becomes less obvious. They may sit at the desk, although their mind can be somewhere else daydreaming. That is why many intermediate school teachers have difficulty picking out students with attention deficit disorder. Instead of jumping up and down, they can be quite fidgety, moving their fingers and feet within their seat. Their fidgetiness can be very subtle, and may not be obvious unless one watches for it. Their minds continue to be hyperactive, with many thoughts going on at the same time.
When these children are old enough to drive, these parents will face a new set of problems. Many of them love to speed. Accidents are much more common. Part of it is speed, part of it is not paying enough attention to the road condition or where they are going.
There is, however, another side to the issue of driving. For some adults with ADD, driving is like heaven. They love driving because it is like a video game that never ends, until they stop their cars. Their “large screen television” is constantly moving with changing scenarios. I have some adult ADD patients who are excellent truck drivers, and they love their job.
Difficulty paying attention continues into adulthood, although some are able to control this enough at work. One of my brothers who have ADD without hyperactivity is still finding it difficult to pay attention. He is the manager of two jewellery stores and has no trouble attending to his clients or employees. However, when he has to sit down for company meetings, he just can’t pay attention. Very often, he would leave the meeting completely lost, and has to depend on his colleagues to go over some important issues afterwards.
You mentioned about your impulsiveness. This is one of the hallmarks of ADD. Impulsive spending can start early, when children spend all their allowance as soon as they get it. Some may even borrow from future allowance.
Impulsive spending can become real tragedy. I have patients who had lost their home because they keep buying, whether they need them or not. Overspending with credit card is an especially difficult problem, because the person cannot visualize that he/she is spending that much money, until the monthly statement arrives. Impulsive gambling is another problem that can happen to some adults with ADD.
Many children with ADD will grow up and become very successful adults. They work in all kinds of professions, including entrepreneurs, lawyers, teachers, nurses, physicians, managers, etc. However, many lead frustrated lives even though they are very intelligent. Their inability to pay attention made it difficult for them to do well in school and at work.
Whether one is successful or not, many adults who grow up with ADD can remember negative comments from their parents, teachers, or their peers. These negative remarks often affect their self-esteem. Many of the adults with ADD that I have seen have used alcohol excessively some time in their life. I don’t mean that all alcoholics have ADD, but alcoholism is very common in this group of individuals.
Recognizing the problem of ADD is the first step. You can begin by learning more about the symptoms of ADD in adults. As I have mentioned earlier, these symptoms can be different from children, and they are often difficult to recognize. There are some very good books written on the subject. I like the two books written by Dr. Edward Hallowell: “Driven to Distraction” and “Answers to Distraction.” They are easy to read and contain a lot of useful suggestion.
Many of the problems that you have can be helped with simple strategies. Physical restlessness can be improved by taking breaks while doing tedious work. Physical activities like running, swimming, or working out in gym can help with concentration. Some adults find that background music (or even television) can help them focus.
If speeding is a problem, use of cruise control set at or below the speed limit will prevent speeding tickets. If you tend to lose your way, draw a map with important landmarks can help. If possible, bring along someone as your navigator.
If organization is a challenge, you should consider using day planners, sticky notes, or electronic organizers. Use of an alarm watch can prevent missing important appointments.
Putting things off until the last minute, also called procrastination, is a problem that plagues most individuals with ADD. This is much harder to deal with than other symptoms. You may want to enlist a “coach” who can be a friend or colleague (preferably not your wife). This coach can help you to schedule deadlines so that you can finish your job on time.
If you use credit cards and overspend, you may want to cancel them all, and use cash as much as possible. In that way, you can really “feel” the pinch when you pay for your purchase. If you want to keep one credit card for emergency use, consider putting it in a container filled with water and stick into the freezer. You will have to wait for the ice to thaw before you can use it, this will give you time to consider whether you really need to use the card.
You may be able to find some counsellors or psychologists in your area that are familiar with ADD. They may be able to suggest to you additional strategies that are relevant to your need.
In many communities across the country, there are support groups for adults and children with ADD. There may be one where you live. You can listen to the stories of other adults and parents; many of them can be very similar to yours. They may have found some useful strategies that you can just adopt.
If you want to find out for sure whether you have ADD as an adult, you will have to ask your family physician to refer you to a specialist who deals with this problem. Many adults who have the diagnosis confirmed are very pleased, because it affirms that they are not lazy, crazy, or stupid. There is actually a name for the problems that they have faced all their life.
Some adults with ADD require medication to help them deal with the difficulties of inattention, hyperactivity, disorganization, or impulsiveness. Whether medication is necessary or not depends on many factors, including their line of work, severity of their problems, and how they affect the family. It has to be a joint decision between the individual and the physician.
Before I close, I want to emphasize that individuals with ADD have a lot of good qualities. Many of them are loving, trusting, friendly, empathetic, kind, energetic, helpful, intelligent…. I can’t possibly list them all here. Therefore, do not only look at the negative side of ADD. Look positive!
[Note to Readers: When I review this column to put on the website, I realize how many years have passed since I wrote this column, in 2000. This condition is now called Attention Deficit Hyperactivity Disorder (ADHD), with different subtypes. Much of the information is the same. Adult ADHD is still not well recognized by physicians or general public. Fortunately, many long-acting, safe, and effective medications are now available to help adults (and children) with ADHD. One can search on Internet to find screening questionnaires for adult ADHD designed by World Health Organization: ASRS v1.1 and ASRS v5. As I transition away from paediatric practice and enter semi-retirement, I will focus my attention on adults with ADHD.]