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Tuesday, June 18, 2013
Attention Deficit Hyperactivity Disorder
24-Year-Old Son with Attention Problems
My 24 year old son has always had difficulty with tasks that do not provide positive reinforcing/stimulating responses. He has great concentration for things that require creativity, detail, and repetition. He enjoys working with his hands. Raising him was extremely challenging because he can be very stubborn/oppositional and would gravitate to activities that he found enjoyable and avoid others. Even though he was good at them he couldn`t make himself focus upon them. He`s very intelligent and has been able to succeed by finding accommodating education opportunities. He`s in a Graduate program now that has a hands-on component but he will have to spend two upcoming quarters in a more traditional grad setting with lots of reading/writing and sitting. He`s very concerned about this phase of the program and so am I. I believe that he has ADD that has gone undiagnosed. Because we took an eclectic approach to his education path and because he`s smart he`s done well but it has not been without a lot of suffering on everyone`s part. He has had clinical depression that I believe may have been partially tied to struggling to fit into a traditional sit-at-a desk high school structure. I also have ADHD as do many of my relatives. It ruined my life and I don`t want my son to experience what I`ve gone through. Thank you.
It is not clear whether you are asking a question or just stating a problem, but your sentiments echo those of many parents I have talked with, both of younger children, adolescents, and young adults. The treatments and accommodations that worked well for children are less appropriate for adolescents and adults. Fortunately, new adult-oriented treatments are being developed, such as CBT and organizational skills training, which adults are more capable of benefiting from than are children.The depression is not all bad if it is truly secondary to the problems. There is some hint in the literature that those with ADHD who are a little depressed do better later than those who have equal severity but are not depressed about it. Mild depression may be a sign of insight and a motivation for change. It's like the bumper sticker "If you are not worried, you just don't understand the situation." Incidentallly, some antidepressants (tricyclics and bupropion) have also proven beneficial for ADHD even though they do not have an FDA-approved indication for ADHD.Three other facts on the plus side for adult ADHD are that:1. There is some evidence that brain maturation is delayed in ADHD, raising the possibility of further improvement with age.2. It is possible to find jobs that suit the proclivity of the individual, more so than finding such a school.3. Habits can be the salvation of someone with attention problems. Once something is habitual, you don't have to pay attention any more. So an adult can start developing good habits one at a time, gradually lightening the attentional burden.
L Eugene Arnold, MD, MEd
Professor Emeritus of Psychiatry
College of Medicine
The Ohio State University