Article: Adult ADHD Significantly Impacts on Social, Financial & Personal Aspects of Life

I was browsing a great science news website I used to spend hours on, Eurekalert.org, and conducted a search for Adult ADHD. I found this useful article that I wanted to share:

"Nationally recognized Attention Deficit Hyperactivity Disorder (ADHD) authority Russell Barkley, Ph.D., has embarked on a national speaking tour to discuss the symptoms of ADHD in adults and the potentially serious consequences these symptoms may have on the life of an adult living with this disorder. ADHD is believed to affect an estimated 8.1 percent of adults, or 9.2 million adults across the U.S. based on a retrospective survey of adults aged 18 to 44, projected to the full U.S. adult population. The purpose of this tour is to help raise awareness about the importance of identifying, diagnosing and treating adult ADHD.

In children, ADHD may interfere with paying attention in school, completing homework or making friends. Difficulties experienced in childhood may continue into adulthood. The symptoms of ADHD in adults may lead to potentially serious consequences. Surveys have shown that when compared with their non-ADHD peers, adults with ADHD may be:

• Three times more likely to be currently unemployed

• Two times more likely to have problems keeping friends

• Forty-seven percent more likely to have trouble saving money to pay bills

• Four times more likely to have contracted a sexually transmitted disease

“This educational initiative is meant to provide information about ADHD in adults including the results of recent studies of adults with ADHD concerning their symptoms, impairments and functionality in many domains of life that support the results of previous research in this area,” said Dr. Barkley author of a recently published book, ADHD in Adults: What the Science Says.

Two studies, one conducted at the University of Massachusetts (the UMASS study) and one conducted at The Medical College of Wisconsin in Milwaukee (the Milwaukee study), were recently published in a book by Dr. Barkley. They were both designed to observe secondary outcomes of patients living with ADHD. These secondary outcomes included: educational and occupational functioning; drug use and anti-social behaviors; health, lifestyle, money management and driving; sex, dating, marriage, parenting and psychosocial adjustment of offspring; and neurological functioning. Observational outcomes showed that adults with ADHD, when compared to a control group, were more likely to use certain illicit drugs, engage in certain anti-social behavior, have financial problems and engage in risky sexual behavior. Outcomes of both studies were observed and documented through a combination of data gathering techniques, such as self-reporting, patient interviews and observation.

“These results, together with what we already know about ADHD, give the impression that ADHD has a potentially significant impact on the lives of many patients. There is hope for adults with ADHD. Today there are ways to manage this chronic condition, and I hope these findings serve as an impetus for adults with ADHD to seek medical advice from their healthcare providers,” said Dr. Barkley.

The UMASS study, conducted from approximately 2003 to 2004, examined lifestyle outcomes among three cohorts of adult patients: 146 clinic-referred adults with ADHD, 97 adults seen at the same clinic who were not diagnosed with ADHD, and also a third general community sample of 109 adults without ADHD. Specifically, the UMASS study found that the adults with ADHD when compared to the non-ADHD control group were approximately three times more likely (21 percent compared to 6 percent) to sell drugs illegally. Additionally, the UMASS study found that 67 percent of adults with ADHD compared to the control group (15 percent) had trouble managing money.

The Milwaukee study, ongoing since 1977 (with the most recent follow-up conducted from 1999 to 2003), is an observational longitudinal study that looked at secondary lifestyle outcomes of 158 children who had been diagnosed with ADHD and, as adults, either continue to experience symptoms or no longer have the disorder at the age of 27, compared to a community control group of 81 children without ADHD who were followed concurrently. The Milwaukee study found that the adults with ADHD were approximately three times as likely when compared with the community control group to initiate physical fights (30 percent compared to 9 percent), destroy others property (31 percent compared to 8 percent) and break and enter (20 percent compared to 7 percent).

“As an organization dedicated to providing information and resources to adults with ADHD, we are excited to see such attention paid to this disorder,” said Evelyn Polk-Green, MS, Ed., ADDA President-elect and adult living with ADHD. “The reason why these findings are so important is that they help to inform people that ADHD is not just a childhood disorder, but in fact, a disorder that may affect multiple aspects of adult life and should be properly diagnosed and treated. This research also reinforces the need for formalized and validated criteria for the diagnosis of adult ADHD and may play a significant role in the development of this diagnostic criteria and the addition of it to the Diagnostic and Statistical Manual of Mental Disorders.”

About ADHD
Approximately 7.8 percent of all school-age children, or about 4.4 million U.S. children aged 4 to 17 years, have been diagnosed with ADHD at some point in their lives, according to the CDC. ADHD is one of the most common psychiatric disorders in children and adolescents. The disorder is also estimated to affect 8.1 percent of adults, or approximately 9.2 million adults across the U.S. based on a retrospective survey of adults aged 18 to 44, projected to the full U.S. adult population. ADHD is a neurological brain disorder that manifests as a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development. To be properly diagnosed with ADHD, a child needs to demonstrate at least six of nine symptoms of inattention; and/or at least six of nine symptoms of hyperactivity/impulsivity; the onset of which appears before age 7 years; that some impairment from the symptoms is present in two or more settings (e.g., at school and home); that the symptoms continue for at least six months; and that there is clinically significant impairment in social, academic or occupational functioning and the symptoms cannot be better explained by another psychiatric disorder.

Although there is no "cure" for ADHD, there are accepted treatments that specifically target its symptoms. The most common standard treatments include educational approaches, psychological or behavioral modification, and medication.

Shire provided financial support for Dr. Barkley’s national speaking tour.

For further information on ADHD please visit: www.ADHDSupport.com or www.add.org.

About Dr. Russell Barkley
Dr. Russell A. Barkley is a clinical scientist, educator and practitioner who has authored, co-authored, or co-edited 20 books and clinical manuals and published more than 200 scientific articles related to the treatment of ADHD and related disorders. He has also received numerous awards over his career for his work in ADHD and the field of psychology. He worked in the Child Neurology Division at Milwaukee Children’s Hospital and founded the Neuropsychology Service at Medical College of Wisconsin. Dr. Barkley also served as the Director of Psychology and as a Professor of Psychiatry and Neurology at the University of Massachusetts Medical School. He also works as a Professor in the Department of Psychiatry at the Medical University of South Carolina and is on the faculty of the Department of Psychiatry at the SUNY Upstate Medical University in Syracuse, NY.

About ADDA
The Attention Deficit Disorder Association (ADDA) is a nonprofit organization working to provide information, resources and networking to help adults with AD/HD lead better lives. ADDA generates hope, awareness, empowerment and connections worldwide in the field of AD/HD by bringing together science and the human experience for adults living with ADHD and the professionals who serve them. For information visit: www.add.org."

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Cheers,

Mungo

Video Documentary & Interviews "My Different Life" - Parental Struggles with ADHD Child

Filmmaker Karen O'Donnell explores the frustrations of Denise Difide, a single mother trying to get the proper care for her three kids, two of whom cope with a learning disability and the third with attention deficit hyperactivity disorder (ADHD). Karen O'Donnell has tackled the issue of learning disabilities in previous documentaries for TVO, in which she shared her own struggles as a parent of child with ADHD.

"My Different Life"


Your Voice - Coping with Special Needs Kids(TVOParents.com)
Cheryl Jackson interviews Karen O'Donnell, the writer, producer and director; Dr. Atilla Turgay, Director of the ADHD Clinic at Scarborough Hospital; and Georgina Rainer, a volunteer educational advocate for parents with children with special needs.

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Cheers,

Mungo

Unexpected News

I got to my appointment on time yesterday, but the receptionist seemed a little flustered when I introduced myself and said that I had an appointment with so-and-so at such-and-such a time. She fretted her brow and asked if I had gotten the phone message about the cancellation of the appointment. I said no I hadn't and asked what I should do. She said she needed to go and speak with someone quickly. So I took a seat somewhat reverently - the tone in the office was very hushed (when I got home I checked both the machine and with my wife, and we indeed had not gotten a message on the machine - a simple mistake).

Then the psychometrist appeared from the hallway and somberly ushered me into a side room off of the hallway. She looked so serious, and I wondered what had transpired that afternoon to distract her so much. She gently told me that she was sorry, but that the meeting had been canceled, and asked if I had heard. I replied with a quiet uncertain smile 'No? Heard what?'

Her body slumped and her eyes began to tear up - the kind, gentle psychiatrist with whom I'd first met, and who was leading my case suddenly passed away a couple of days ago. She looked lost and very sad - and still couldn't believe it had happened. She'd worked with him for nearly two decades - he'd taken her under his wing. She looked so sad.

We spoke for a few minutes, and at the end I arranged with her for another appointment in a couple of weeks - they'll need time to transfer the cases over and to recover from the utter shock. I will repeat the first meeting with an associate psychiatrist - one who had trained under this man - with the benefit of his original notes, and the fact that he and the psychometrist had spoken about my case afterward. I will then have the meeting I had appeared for yesterday - with a clinical psychologist.

She said that you'd have never known - because of his humble and kind nature - but if you did research on him, you'd learn that he was 'a giant in the field of psychiatry', highly accomplished and talented. He would treat millionaire CEOs exactly the same as a young custodian mopping the floors. He had an otherworldly nature about him. He was their 'light', she added with a hopeful and wistful smile.

I am sad and was shaken all last evening by it.

Take care,

Mungo

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Cheers,

Mungo

My Second Appointment - Coming Up!

Well, my second appointment is coming up this afternoon. A bit nervous, but so it goes...

Cheers (wish me luck),

Mungo


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Cheers,

Mungo

Videos: More in a Series by Dr. Russell Barkley, Ph.D at the Centre for ADD/ADHD Advocacy, Canada

Below please find more in a series of videos I found on the CADDAC - Centre for ADD/ADHD Advocacy, Canada web site on coping strategies, self-control development and the neuro-anatomy of ADHD by Dr. Russell Barkley, Ph.D.


Coping Strategies in Parents with ADHD


Neuro-Anatomy of the Disorder: Part 1 of 2 - ADHD is a Disorder of Executive Functioning


Neuro-Anatomy of the Disorder: Part 2 of 2


How Normal Self-Control Develops

Cheers,

Mungo

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About an Adult ADHD Diagnosis: Who to Tell, & What to Say, & How to Tell, & When to Say, & Should I Say It At All?

This coming Tuesday afternoon I'll be attending the second of three appointments at the ADHD clinic.

The first one of course was where I spent about four hours meeting with a psychiatrist and then a pychometrist answering a boat-load of questions. I started off writing a series of psychological measures, everything from depression and anxiety tests to ADHD symptom tests and a psychiatric, medical, family, and historical questionnaires. I ended off the session participating in a computer test that appeared to measure my attention. I had to hit the space bar a lot when certain stimuli appeared in front of me. Despite my best efforts, I hit the space bar when I wasn't supposed to several times. It is hard to pay attention for a long time, says I.

At the end of the appointment, they gave me a blank paper test - one very similar to one I had written measuring symptom severity and life function measures, to give to someone close to me who knows me well. So I gave it to my wife who filled it in that very night. While ADHDers often can be very intuitive and perceptive of others (due to the multiple channels of attention to which they are unintentionally paying mind), sometimes they're not always the best judge of their own ADHD behaviours. It is useful to compare the views of someone close to you, along with your own, to strengthen and validate the observations.

So this coming Wednesday, I'll meet with a clinical psychologist. I don't know what the agenda will be. And the third meeting, still to be scheduled, will probably be a consultation where they review the results of the tests, provide some sort of diagnostic instruction, and hopefully recommend a course of treatment. The course of treatment might be counseling and/or medication, or a long stint in a rubber room, with my very own straitjacket. I'll ask for mine in green, my favourite colour.

All of this takes place during at time when I am discovering new perspectives with myself, and working towards getting a diagnosis and treatment. This will affect me. But it will also affect my friends and family and people I know in various arenas of life.

It begs the questions: who, what, how, when, or even should I let them know?

I crossed a big hurdle yesterday when I went out to my hometown. My wife, me and my little boy dropped by my parents' house to say hello. And I ended up going out for a long walk with little boy and my mum. We walked through the town pushing the little boy while he slept in his stroller through grassy parks and down by the lake, chatting and looking at the new spring growth, the birds and the animals, and the lake. The air was cool and the sun was warm.

All the while my mum and I chatted. I spoke most of the time. She had asked when my next appointment would be, as I'd previously let her know a bit about what was going on with me. So I told her a little about the first meeting, and she asked about what sort of questions they ask.

"Maybe before I answer that, I could go into a bit about what all this ADHD stuff is all about, and then I could better describe the questions if you don't mind me going into some detail", I offered. I wasn't sure how she'd react, and I wanted to gauge whether she felt comfortable talking about it.

She wanted to hear, so I spent the next hour chatting with her about it. She asked me questions, I told her about what I'd read and learned. About the neurobiological basis of ADHD. The fact that it was relatively unknown in adults until recently. The genetic heritability (0.8), and what that means. The inconsistent attention, the impulsivity, the hyperactivity, the daydreaming and zoning out. The different criteria and diagnostic subtypes. The morphological differences that are believed to exist in the various parts of the brain. I spoke about the difference between the white matter, the corpus collosum, and the crenellations of grey matter in the pre-frontal cortex, and the executive functions that are impaired. I also dove a bit into the circuitry and the neurotransmitters, the receptors, and how stimulants like Ritalin are believed to work - comparing them a little to SSRIs in depression. The various parts of the brain that relate to the governance, maintenance and control of attention, and how it is surmised that in ADHD folks, there are neurophysiological differences. I spoke about specific symptoms and of comorbidities of anxiety and depression, and how they related to what scientists know about ADHD. I talked about specific behaviours I've observed in myself, others have observed in me, and she tossed in a few authentic and very interesting observations as well.

Happily I could tell she was synthesizing all of this information. She'd felt bad initially when I told her, she related, because she wondered how she could have known, and why she didn't pick up on this when I was younger. But I reassured her, explaining that really most of the symptoms of ADHD are within the normal range of people, but just amplified to a large degree. It's not like I was hallucinating, or having seizures or something that obvious. Plus people didn't know much about it when I was a kid. ADHD blends into the background of the crowd, I said. I spoke about my historical and school and interpersonal and vocational experiences. I spoke about my emotional and personal experiences. I spoke about the turmoil, and sense of multiple channels being on at all times, the distraction, the failures, and the searching for something that made sense to describe it all.

And along the walk, a chipmunk appeared, or a new spring bird. And I was naturally drawn to them and interrupted the conversation. That's the nature boy side of me. I was completely thrown off my game though when a loud motorcycle began revving its engines near the stroller where my baby slept. When we were approaching a noisy leaf blower. Even when we saw people sitting on the sidewalk. I had to push hard to keep my focus on the conversation. I guess I allowed myself to pause and allow myself to get lost for a minute or two.

I spoke about how attention can be sustained with an ADHD person when that subject or experience is perceived to be very interesting, and yet how it is lost in repetitive, boring tasks, or when something else interrupts or suddenly appears. How when emergencies happen, I'm calm and able to focus on the big picture and will end up directing traffic (in the case of a streetcar/pedestrian accident I witnessed a few years ago), or carrying someone out of a crashed car, up a mountain slope (back in high school, after having been in the accident itself while sitting in the passenger seat) to safety, to more everyday excitement that takes place at my workplace when computer systems are down or faulty and something needs to be done quickly. To some degree ADHD contributes to my successes and unique approaches. And of course contributes to my failures and struggles and interpersonal difficulties.

The signal to noise ratio metaphor is especially compelling to me. When my ADHD (as yet undiagnosed of course) is full-on, I find it hard to isolate a clear signal in the noise taking place around me. I either need to (when I'm at work for example) close my door, or go for a walk, or close my eyes, or shake my leg anxiously when it gets really noisy around me. Or if I'm in a mall, and holding a conversation with someone - I fight to maintain my attention to the conversation. I must look like I'm in tertiary stage syphilis, with a rigid grin on my face, eyes unblinking and unbelievable tension affecting my neck and jerking bodily movements.

I exaggerate a teeny tiny bit, but you get the drift.

I also spoke about the beneficial aspects of an ADHD's person's experience - the ability to sensitively read body language, gestures, environmental signals and various channels of information, above and beyond the merely spoken words in a conversation, that non-ADHDers might not notice. The tendency of ADHD people to have varied interests, various hobbies, and - in my case - a broad range of intellectual interests.

Sometimes that's good. Sometimes that's bad. In novel situations and meetings it can be somewhat useful to watch body language, but in routine business meetings it is probably best to focus on mostly what is being spoken. If you're in a casual or even a dangerous situation, it is useful to have your ADHD multi-channel wits about you. I can bring to bear my knowledge of many arenas of interest onto problems and 'think outside of the box', coming up with novel and non-linear solutions to problems. I have three active blogs and one coming online shortly, a story I have been trying to write over the past few years. Maybe that'll be one of my new projects if I can focus on it!

I went on and on (as I am prone to do). And my mum listened. She remembered comments from teachers and letters she'd written me when she was at her last wits with me in my teens and early twenties.

By the end of the walk, I think we were both feeling better. My heart rate was slower; the nervous buzzing in my hands had left. My mum was inquisitive, relaxed, curious and seemed to be thinking a fair bit. We talked a little about who in the family might also have it. But that's another post.

So that went well. But once I'm through the diagnosis and the start of treatment, who else do I tell? I'll tell a couple of my close friends, and a business colleague I'm close with. My wife knows and hopefully she'll see improvements and changes in my behaviours, and attain new insight along with me about this ADHD stuff.

My little boy is at the stage that he knows the difference between his milk bottle and his breakfast pablum and between his various bath toys, but I'll need to wait for a few years to tell him. I won't need to tell the dog. He wouldn't care either way; he wags his tail no matter what - I can always rely on the dog.

At this point, other than what I've said above, I'll probably keep it mostly private - on a 'need to know' basis, unless I really trust a person. Oh, except with all of you readers... :-) Because many folks either don't 'believe' in ADHD, or understand what it is - and I totally get that, and many people have taboos about crazybrainstuff. In that they figure it's all crazybrainstuff.

Well, that's all for today.

Cheers,

Mungo

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Symptomatic & Behavioural Red Flags for Adult ADHD

Here is a useful list of 'red flag' symptoms and behaviours that may indicate the possibility of Adult ADHD. This list is found on the website of CADDRA, the Canadian ADHD Resource Alliance. Note that obviously not all of these will be present in a given individual with Adult ADHD. Typically we develop coping mechanisms as we grow out of childhood and our juvenile years, such that we find ways of successfully coping with the drawbacks and deficits of ADHD.

Red Flags for Adult ADHD

• A lifelong history of difficulty with attention
• A history of disruptive or impulsive behaviour
• Organizational skill problems (time management difficulties, misses appointments, frequent late and unfinished projects)
• Erratic work history (changes jobs frequently, unprepared for meetings, projects not completed on time, reports of coworkers, employers and clients being frustrated with them)
• Anger control problems (argumentative with authority figures, over controlling as a parent, fighting with coworkers or child's teachers, episodes of rage)
• Marital problems (spouse complains that he/she does not listen, speaks without thinking, is impulsive, forgets important events)
• Being over-talkative, interrupts frequently or inappropriately, speaks too loudly
• Parenting problems (difficulty establishing and maintaining household routines, inconsistency in dealing with the children)
• Money management problems (making impulsive purchases, running out of money, failing to pay bills or do taxes, history of bankruptcy)
• Substance use or abuse, especially alcohol or marijuana, or excessive caffeine use
• Addictions such as collecting, compulsive shopping, sexual avoidance or addiction, overeating, compulsive exercise or gambling
• Frequent accidents
• Problems with driving (speeding tickets, serious accidents, license revoked, or being overly cautious when driving to compensate for attention problems)
• Being a parent of a child with ADHD
• A college student who is frustrated, having to reduce their course load, or having difficulty completing assignments
• An ADHD diagnosis as a child and continuing to have problems
• Reports from those close to the adult that they are just like a child or relative with ADHD or identifying them as having many of the symptoms associated with adult ADHD
• Evidence that the adult is not just coping poorly, but is significantly impaired and is at high risk of developing secondary disorders such as anxiety and depression
• The adult may be successful but shows impairment when compared to their potential
• An adult who is expending more energy than others to do the same amount of work
• An adult who is using coping strategies to compensate for their weaknesses, but still experiencing problems with their career and work relations or becoming a workaholic
• An adult who self-diagnoses, but still needs to go through a complete assessment

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Cheers,

Mungo