Attention Deficit Disorder Can Strike Adults Too, Researchers Warn

Red-faced mothers and fathers whispering, “Me too,’ have alerted doctors that Attention Deficit Disorder doesn’t play havoc just with children. It also can devastate adults.

“I thought I had Alzheimer’s,” said Howard Morris of Ann Arbor, Mich., who was diagnosed with ADD three years ago at age 38.

Morris is a board member of the National Attention Deficit Disorder Assn., a Mentor, Ohio, organization that held its second conference for adult sufferers in Pittsburgh in May.

The idea of adults suffering from the disorder is new enough that the first textbook for therapists is only a year old, and most clinics for adults are just getting off the ground.

“My prediction is by the year 2000, this will be near the top of the list of serious health care problems that we face,” said Dr. Craig Liden, president and senior medical director of four Transact mental health treatment centers in Pennsylvania. They have treated about 7,000 adults and juveniles with ADD.

ADD sufferers are at least six times more likely to cause car accidents and four times more likely to have drug and alcohol problems, Liden said. About 75% of his ADD patients are overweight, he said. And ADD often leads to criminal behavior, depression or anxiety.

The National Attention Deficit Disorder Assn. estimates that 3% to 5% of adult Americans have ADD. Robert Resnick, president of the American Psychiatric Assn., says about 2 million adults have been diagnosed so far.

Not all of them are hyperactive. They are, however, crippled by an inability to control their attention. Most sufferers cannot focus on work, get organized, finish projects or stick with conversations, doctors say. Their minds are constantly receiving input that most people can block out.

“You’re sitting there talking to somebody, and their eyes are blue, but they’ve got a little dot of brown in one eye. It can completely throw off your conversation,” Morris said. “These little things on a continuous basis--second by second--just completely distract you.”

Before treatment, Morris would misplace his keys daily, leave many projects unfinished, fail to recall his wife’s name during social introductions and even forget during TV commercials which show he was watching.

Researchers still debate the cause of ADD, but most agree sufferers have a genetic malfunction in their neurotransmitters, chemicals that fuel the attention and impulse centers of the brain. Either the chemicals are in short supply or they are improperly relayed, Liden said.

The malfunction apparently repairs itself in about a third of children with ADD, but the others experience mild to severe symptoms as adults, said David Feifel, director of the adult ADD program at the University of California at San Diego.

Amphetamines such as Dexedrine and Ritalin, known for calming hyper children, boost the flow of neurotransmitters. They help ADD sufferers focus and relax.

Many sufferers who are unaware they have the disorder effectively will medicate themselves by smoking or drinking a lot of coffee. Others will procrastinate projects subconsciously to push their brains to a stimulating “panic point,” said Nancy Ratey, co-founder of the National Coaching Network, a group of counselors for ADD sufferers.

“Usually my clients want to stop this kind of madness,” she said.

Some doctors dispute that ADD is a legitimate disease, however, because a specific neurological cause has not been pinpointed.

Bert Karon, a professor of psychology at Michigan State, said an ADD diagnosis that involves medication is a “quick fix” that fails to solve the problem in the long run for many patients. Karon and others say ADD is most likely a collection of symptoms that are best treated with psychoanalysis.

For about 20% of patients, prescribed medication fails, said Harvard researcher John Ratey, Nancy Ratey’s husband and author of one of the first academic papers on adult ADD in 1986. Stimulants can wear off too fast to be the sole treatment for others.

Therapists and coaches spend a lot of time helping sufferers straighten up their messy lives.

By the time they mature, most hyperactive ADD sufferers have suppressed their juvenile jumpiness into small movements, such as drumming their fingers, feeling a constant urge to get up from their desks or irresistibly glancing out the window.

Therapists try to teach sufferers to minimize distractions by keeping their desks clean and away from office bustle, according to Resnick, director of Virginia Commonwealth University’s Attention Deficit Disorder Clinic. Ratey requires each client to make numerous lists and to keep a detailed calendar of plans.

Two other ADD tendencies--to interrupt impatiently and to speak impulsively--often lead to problems at work.

“We had one guy in our program: 30 jobs in 30 years,” Resnick said.

Clinicians say just alerting patients to these problems can lead to control.

“Once I saw the fact that I knew what was wrong, I was motivated to do better,” said James Wood, 24, who was flunking at Virginia Tech when he was diagnosed with ADD four years ago.

Dexedrine was prescribed, but Wood also learned to change his life.

First, he changed his major from business to the more visual, hands-on field of interior design. He restructured his study time into shorter, 40-minute bursts. And he wrote notes from his texts before classes to focus on lectures.

When he graduated in May, Wood was on the dean’s list.

The lack of control over attention paradoxically causes sufferers to “hyperfocus” sometimes, usually when they are keenly interested in a project, said Kathleen Nadeau, author of “Adventures in Fast Forward: Life, Love and Work for the ADD Adult.” Their brains will stop accepting any outside signals.

Women have an especially tough time living without treatment because they are often expected to be caretakers, Nadeau said, while men more often can depend on secretaries or spouses to keep them on track.

Doctors agree that stress, illness and mental problems such as depression can create temporary ADD symptoms. They look for the consistent disruption of a patient’s life by ADD symptoms and a family history of the disorder.