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A Lifetime of Distractions
I posted this for the benefit of any new ADDult members who have joined us recently.
Nova http://articles.health.msn.com/id/100098797/ A Lifetime of Distractions By Harvard Health Publications ADHD is no longer just a children’s disease. Many adults are being diagnosed and treated for the condition. Although we usually think of attention deficit/hyperactivity disorder (ADHD) as a problem affecting squirmy schoolchildren, it can be a lifelong disorder, an unwelcome and unruly childhood companion that can follow you all the way to old age. Brain imaging studies are finding distinctive patterns of neural activity in ADHD adults that match those in ADHD children. Family studies of parents and close relatives of ADHD children turn up statistically significant numbers of ADHD adults. Studies of twins (identical and fraternal) reared in the same home environment have shown ADHD to have the highest heritability of any psychiatric disorder. It has nearly twice the heritability of asthma and three times that of breast cancer. Genetic studies of ADHD "carriers" have zeroed in on a number of genes involved in the regulation of dopamine, norepinephrine, serotonin, and other neurotransmitters. No one expects to find a single ADHD gene, but further research into the complex molecular biology that underlies memory, attention, and how we make up our minds could sharpen drug treatments for ADHD — and uncover new ones.
The prevalence of ADHD remains a major controversy. The low-ball estimate is that 1% of adult Americans are ADHD-afflicted, but some experts say it’s as much as 6%, which would work out to about 10 million people. On the other hand, another study came up with a figure of only 0.5% among 40-year-olds. Disputes over these statistics reflect deeper questions. Does untreated ADHD explain unhappy lives filled with crime, drugs, and underachievement? Or is this another case of medicalizing a more diffuse problem? What does it look like? Perhaps the clearest picture of adult ADHD comes from studies of people originally diagnosed with ADHD in grade school and followed by researchers through adolescence and young adulthood. These studies vary widely in their estimates of ADHD prevalence, remission rates, and relationship to other psychiatric disorders. But over all, they show a high percentage — 80% in several studies —of ADHD children growing into ADHD adolescents. Such individuals have continual trouble in school, at home, on the job, with the law in general, and with substance abuse in particular. Compared with control groups, ADHD adolescents are more likely to smoke, to drop out of school, to get fired, to have bad driving records, and to have difficulties with sexual relationships. "There’s a great deal of continuity from the child to the adult form," says Russell Barkley, a researcher at the Medical University of South Carolina. "We’re not seeing anything that suggests a qualitative change in the disorder. What’s changing for adults is the broadening scope of impact. Adults have more things they’ve got to do. We’re especially seeing problems with time, with self-control, and with planning for the future and being able to persist toward goals. In adults, these are major problems." Poor time management is a particularly treacherous area. As Barkley observes, "With a five-year-old, time management isn’t relevant. With a 30-year-old, it’s highly relevant. You can lose your job over that. You can lose a relationship over it."
Childhood ADHD is divided into three categories: primarily inattentive, primarily hyperactive-impulsive, and a combination of the two. What these variants "grow into" in adults is an open question. Most experts agree that pure hyperactive behavior usually diminishes with maturity: Few ADHD adults are completely unable to stay in their seats. Yet many ADHD adults are restless fidgeters and pacers. The picture of adult ADHD is clouded by the question of psychiatric "comorbidities" — other disorders that are distinct from ADHD but can complicate the condition. Young ADHD adults generally have higher rates of antisocial personality, anxiety, depression, and substance abuse. How is it diagnosed? After a thorough physical exam to rule out other problems, clinicians question patients using standardized lists of ADHD symptoms to come up with a score on severity and persistence. The results are assessed in the context of a developmental, psychiatric, and family psychiatric history, including the patient’s prenatal, childhood, and school history. Clinicians can also draw on an assessment of the patient’s behavior by family members or on a patient’s reporting of childhood experiences. The reliability of retrospective self-reporting is a point of contention. Some studies suggest that it leads to underdiagnosis; others, to overdiagnosis. Experts agree that there’s no such thing as adult-onset ADHD. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a childhood history of ADHD symptoms, whether they were recognized, treated, or ignored at the time, is essential for a diagnosis of adult ADHD. But establishing a childhood history is easier said than done. If you were born before about 1965, you’re probably too old to have grade-school records that use a label like hyperactive. Over-40 hyperactives belong to the "runs with scissors" generation. Children with attention problems were often just thought of as lazy or daydreamers. A study of about 850 adults with ADHD published in the Archives of Internal Medicine earlier in 2004 found that only a quarter of them had been diagnosed with the condition as children or teenagers. Psychiatry itself has muddied the waters by switching its labels. ADHD has supplanted attention deficit disorder and another diagnosis called "minimal brain dysfunction." The definition of ADHD has evolved from emphasizing hyperactive behavior to recognizing more complex neurological deficits involving the brain’s executive functions. Under newer definitions, non-hyperactive adults are more likely to pass the diagnostic threshold for ADHD, thus raising the overall prevalence. Happy endings Salvatore Mannuzza and Rachel Klein of the New York University Child Study Center, who conducted widely cited research on ADHD children aging into ADHD young adults, point out that statistics don’t tell the full ADHD story. Yes, their studies, like others, show trouble with jobs, education, and self-esteem. But nearly all of their subjects were gainfully employed. Some had achieved higher-level degrees and admission to medical school. Adult ADHD may be a lifelong disorder for some, Mannuzza and Klein conclude, but they can go on to achieve educational and vocational goals just like anyone else. ADHD precludes nothing.
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- You don't seem, like a very good Vampire... What, is it, that you, do? - I, can bring, you, back, to Life. -True Blood |
The Following 5 Users Say Thank You to Nova For This Useful Post: | ||
chaconie (09-20-09), chowmix (12-25-08), LoriRedd (04-17-11), sarek (12-26-08), ZonkedMocha (06-23-12) |
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Nova,
Thanks. I appreciate the accuracy of the info. Bob
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I think the conviction and the intensity and the passion and the sincerity - the honesty - you feel these qualities when you hear this record, and that's what makes it so compelling - Joshua Redman on Trane's "Love Supreme" It is what makes us ADHDers compelling also - Bob1951 |
The Following User Says Thank You to Bob1951 For This Useful Post: | ||
Nova (03-04-09) |
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![]() [font=Comic Sans MS]Hi Nova,
![]() Thanks for sharing such an interesting article. I was born before some ten years before 1965 and while A.D.D was not readily recognized; school report cards would have shown some propensity for A.D.D in the Conduct section. Likely as not, teachers would have red check marks for things like: Teacher says, A. D.Der says Does not try......... {Duh, Teacher it's too hard!} Talks too much. . .. {I have too much to say} Fails to turn in homework, { I was hyperfocused on WoodyWoodpecker show} Does not pay attention, { The radiator hiss is distacting and the swirled colors in Kathy's pencil is more interesting than math Disturbs others, {"Hey, Kathy, Can I see your pencil? Can you get me one too?' Yah-h-h, Bring it tomorrow, Okay?"} Fails to Complete assignments, etc. {Homework's Boring!} All symptoms of A.D.D long before it was recognized if they had only looked at what was right under their noses. A, D.D'ers are Spontaneous, Fun, Think Outside the Box. Creative, Smart, Loveable, That's me, Odd-Scrooball ![]() ![]() ![]() |
The Following User Says Thank You to ~Ødd~Scr~θθball For This Useful Post: | ||
Nova (03-04-09) |
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Just finished reading all your posts...scrooball THANK YOU especially.
After the day I've had today ?....I REALLY needed that laugh. Redrover63 |
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Thank you for that article Nova. As an undiagnosed 40 year old, who only just discovered this - it gave me goosebumps. It describes me perfectly.
Quote:
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ADHD, GAD-Social Anxiety with OC tendencies and Depression, Alcoholism 17 yrs sober. "PARADISE... is exactly like where you are right now, only much... much... better..." - Laurie Anderson I must've gotten here late because I didn't get the hand-out... |
The Following User Says Thank You to busyhermit For This Useful Post: | ||
Nova (03-04-09) |
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Re: A Lifetime of Distractions
Quote:
I would have to think that this may be a large part of what constitutes the paradox of the disorder being both overdiagnosed and underdiagnosed. |
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