Men Who Can't Concentrate: Adult Attention Deficits

by Charles Downey

A Massachusetts woman was disgusted with her husband. He flitted from job to job,
could never finish a task, lost his temper over the most trivial things, fidgeted constantly, couldn't remember what
he said yesterday, drank too much and considered his own needs first. Often, his temper prevented him from
getting along with others on the job and at home.

One day his wife, an elementary school teacher, told her husband he acted just like the third grade boys in school
who had been diagnosed with attention deficit hyperactivity disorder (ADHD) and were medicated to overcome
it. Her husband was eventually diagnosed with the disorder.

ADHD in Adults
Attention deficit hyperactivity disorder is not just for children anymore. Experts say about one-half to two-thirds
of all ADHD cases (two to five million) occur in adults. Moreover, ADHD is five to seven times more common
in males. Until recently, many in the helping professions believed that most symptoms largely disappear in
adolescence.

"The disorder was often missed in childhood, so a man often isn't diagnosed until his wife absolutely insists on
marital counseling," says Mary Bellis Waller, Ph.D., a psychotherapist and scientist at the Center for Addiction
and Behavioral Studies in Milwaukee, Wisconsin.

"Most adult males with ADHD show a great deal of impulsivity in starting and ending relationships, difficulties
holding onto jobs and money, and heavy involvement with drugs and alcohol," says psychologist Eliot Goldman,
Ph.D., coordinator of the adult ADHD clinic at North Shore-Long Island Jewish Health System on Long Island.

Males with ADHD rarely wear wrist watches and also have a lousy sense of direction, so they frequently get lost
while driving. Many college men with ADHD become addicted to Internet surfing because the medium is flashy
and you can easily go to another web page once the novelty wears off.

Unfortunately, a large percentage of adults with ADHD have other conditions as well, in particular mood
disorders, substance abuse, antisocial personality disorder, and learning disabilities.

Heredity
According to Arthur Robin, Ph.D., professor of psychiatry and behavior neuroscience at Wayne State University
School of Medicine, recent research reveals ADHD is largely passed on through heredity.

A study of identical twins found that in 81% of cases, if one twin had ADHD, the other also had it (a condition
known to scientists as concordance). But a study of fraternal twins found concordance in only 29% of those
siblings. Another study of twins revealed 67% concordance in identical twins, but zero for fraternal twins.
Additionally, researchers in the area of molecular genetics have discovered a link between a particular gene
known as DRD4 repeater gene and ADHD. That's the same gene that has previously been associated with the
personality trait of high novelty seeking behavior.

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Making it Work
Some men with ADHD actually harness it for on-the-edge careers as race car drivers, oil riggers, policemen,
entrepreneurs, stock brokers or other jobs that require considerable vim and vigor. Unfortunately, men with
ADHD may also have short attention spans, be easily distracted, unorganized, and subject to temper tantrums that
make them less than perfect people persons.

The Feelings of ADHD

"It's like having a whirlwind in your mind," said one man with ADHD. Everything seems to be blowing around
and nothing stays put. It can also be like watching someone change channels on the television every few seconds.
You can get a general idea of what is going on, but you miss most of the content."

Adds Dr. Robin, "Generally, people with ADHD are at the mercy of their moods. An odd idea pops into their
minds and they follow that until another off-the-wall notion crops up." With an inability to think matters through,
people with ADHD act on too many impulses and often become ensnared in the legal system.

Living with ADHD

While there is no cure, symptoms can be managed with prescribed medications like Ritalin, Dexedrine and
Adderall. Some men keep themselves on track by using day books, computers and tape recorders, and by posting
schedules and appointments throughout the home and office and learning better time management skills. Men
who seek professional help learn to find additional relief in regular exercise, maintaining a sense of humor,
reducing negative thoughts about themselves, reducing alcohol and drug use, and enlisting a friend to help them
finish tasks and remember commitments.

Most adults with ADHD can and do lead successful personal and professional lives. One physician diagnosed
with ADHD used his tremendous energy to see an unusual number of patients during a typical day. But he knew
he was weak on follow-through so he turned down complex cases that involved many details and outside
consultants.

Another was a real estate salesman, who was a flashy glad-hander and who could charm the fangs out of a
rattlesnake, but found his commissions drying up. While undergoing treatment for ADHD, he discovered his
office was totally disorganized, which made it unable for him to follow up on leads. It took a year to set up a
filing system that has put his income back on track.

"About half [of these men] are helped by medications. The other half improve their lives by learning how to get
organized and pay attention to details," Dr. Goldman says.

The Bright Side

ADHD does have its upside. As listed in a recent edition of ADDitudes, an on-line magazine for people with
ADHD, there are at least 10 benefits to ADHD:

1. Boundless energy and enthusiasm

People with ADHD frequently have the energy and stamina to persist with sports and other demanding activities
without slowing down or losing strength.

2. Innovative thinking
People with ADHD, who often feel less bound by rules and tried procedures, frequently are able to "think out of
the box" and come up with inventive solutions. Albert Einstein is thought to have had ADHD.

3. Curiosity
People with ADHD frequently are more curious than others. Their tendency and ability to hyperfocus impels
them to ferret out information and details in a wide variety of areas.

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4. Emotional intuition
People with ADHD feel their emotions strongly and often have an uncanny ability to be "in touch" with their
emotions, as well as the emotions of others.

5. Great memory for minute details

While most of us tend to remember the big picture and forget the details, people with ADHD are just the
opposite. Their exceptional recall for details makes them an asset on team projects.

6. Acceptance and forgiveness of others

Perhaps because of their own trying social experiences, people with ADHD tend to be more accepting of others'
foibles and more forgiving of others' mistakes.

7. Embracing risk and change

People with ADHD are often more willing to take risks to achieve their goals. They are unafraid of change and
enjoy the challenge of adapting to new ways of doing things.

8. Persistence
People with ADHD bounce back more quickly, and more often, than most other people. When confronted with
negative feedback or failure, they are more likely to persist in overcoming obstacles and criticisms.

9. Sociability
Their energy, creativity, and love of excitement is a tremendous social asset. People with ADHD often find
themselves motivating and energizing large groups of friends and co-workers.

10. Creativity
Many people with ADHD are exceptionally creative and productive visual artists, performers, composers, and
writers. Beethoven and Mozart are both believed to have had ADHD.

RESOURCES:

National Institute of Mental Health, National Institutes of Health

http://www.nimh.nih.gov/publicat/adhd.cfm

Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD)

http://www.chadd.org

National Attention Deficit Disorder Association

http://www.add.org

ADDitude Magazine
http://www.additudemag.com

Last reviewed June 2003 by Rosalyn Carson-DeWitt, MD

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