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Mindful : April 2016
The other big myth about ADHD is that it’s only a problem for kids. True, the disorder typically arises in early childhood, detected by vigilant parents and teachers. At last count, more than 6 million youth—one in nine kids between four and 17 years old—have been diagnosed, according to the Centers for Disease Control and Prevention. To be sure, the number of adults diagnosed is less clear—we’re much less carefully tracked, and many of us have learned to cope with and disguise our symptoms—but research- ers believe that serious symptoms persist into adulthood for more than half of all children who have the dis- order. A 2006 survey by the National Institutes of Mental Health estimated that 4.4% of Americans aged 18 to 44 suffer some degree of disability from ADHD. That works out to roughly 10 million Americans. In a startling milestone, in 2015 the number of American adults taking ADHD medications surpassed that of children, accounting for 53% of some 63 million prescriptions, according to data compiled by Shire Plc, which makes the top-selling Vyvanse treat- ment. The number of adult prescrip- tions is now increasing twice as fast as that of the overall market. From this, we can infer that millions of adults are seeking help to cope with distraction. But—alas—we can’t infer that they’re actually being helped. Research suggests that prescription medication, usually in the form of stimulants such as amphetamines or methylphenidate (brand name Ritalin), can help about 80% of those diagnosed with ADHD. But quite often even when people find that the meds improve their focus, they can’t tolerate common side effects including insomnia, loss of appetite, high blood pressure, and irritability. That’s just one reason many experts I’ve inter- viewed consider medication as simply one potential tactic among many possi- ble approaches, all of which have their strengths and weaknesses. (See “What You Can Do About It,” page 40.) And that brings us back to mindful- ness, which is gaining new respect → Time to See a Psychiatrist? “It’s natural to wonder to what extent this is a culturally created disorder, given that pretty much everyone these days feels distracted and overwhelmed,” notes Oregon Health & Science University psychiatry professor Joel Nigg, author of What Causes ADHD? But how can you tell for sure whether you have a genuine biological malady or merely a brain that has been Twitterized? There’s no blood test or brain scan (despite what you may have heard) that can diagnose ADHD—or any other psychological disorder, for that matter. Instead, a clini- cian will ask you questions from a checklist of the classic symptoms—forgetfulness, distractedness, impulsivity, and difficulty finishing tasks— and deliver a diagnosis only if those problems are chron- ically impairing your per for- mance at school or at work. For a preview, you can ask yourself a few questions. Do I have more problems priori- tizing my work and activities than most people I know? Do I have more trouble planning ahead than almost anybody else I know? Do I very frequently make care- less mistakes and fail to finish tasks on time? Has this been typical of me for a long time? (Note here that the vast majority of people who have ADHD have had substantial symptoms by age 12.) Is there no other obvious expla- nation, such as drug addiction, a head injury, a sleep disorder, or— we really hope not—early signs of dementia? Have these issues caused me clear problems in my work and/ or relationships? Do I have any (and possibly many) close relatives also suffer- ing from chronic distraction and impulsivity? Think you might have ADHD? Here are some initial questions to ask yourself. With thanks to Joel Nigg, author of What Causes ADHD?, to Kathleen Nadeau, author of ADD- Friendly Ways to Organize Your Life, and to the authors of the paper “Struct ure a nd Diag nosis of Adult Attention-Deficit/Hyperactivity Disorder.” ? 1 2 3 4 5 6 7 April 2016 mindful 39