could you have ADHD?

Section: SECTION 4 mind
STRESS

You may be writing them off as bad habits. But problems with focus and follow-through might actually be symptoms of a syndrome that, as it turns out, isn't just for kids.

FOR YEARS, Kimberly Majerowicz had felt that she wasn't living up to her potential. Sure, the 37-year-old Timonium, Maryland, resident had always held good jobs, first in medical sales and then in interior design. By all objective measures, she appeared successful--but inside she was struggling. Most days, Majerowicz was lucky if she could manage to sit down and focus for four hours. The rest of the time, she'd flutter from task to task, doing more procrastinating than anything else. "I was completely overwhelmed," she says. "I couldn't make a plan and stick to it."

Things only got worse. Majerowicz started having problems with her 15-year-old daughter, Danielle. Not only were her grades falling, but she was also sneaking out of the house at night, drinking, and experimenting with drugs. Too, she fought with her mother constantly. Desperate, Majerowicz took Danielle to her doctor. The diagnosis: attention-deficit/hyperactivity disorder (ADHD), a neurobiological condition marked by inattention, impulsivity, disorganization, and sometimes hyperactivity.

Danielle got help, and, as it turned out, so did Majerowicz. Reading the pamphlets as she waited for her daughter in the doctor's office, Majerowicz found herself wondering if she could have ADHD, too. A few weeks later, a psychiatrist's evaluation confirmed her hunch. The doctor gave Majerowicz a prescription and talked to her about ways to manage the disorder. Suddenly, she started gaining the ability to focus, and her new organizational skills helped her become more efficient.

"I was meant to be successful," Majerowicz says. "I just had something wrong with me chemically."

Once thought of as a problem only of rambunctious little boys, ADHD is now known to strike girls, too--and often to persist into adulthood. According to the American Psychiatric Association, 3 to 7 percent of children and 4 percent of adults have ADHD. Yet the disorder is still frequently overlooked or misdiagnosed in women, says Patricia O. Quinn, M.D., executive director of the National Center for Gender Issues and ADHD, a nonprofit organization that focuses on the needs of girls and women with the condition.

That's because ADHD plays out in more subtle ways in females as compared to males, who tend to have the bouncing-off-the-walls behavior that makes the affliction hard to miss, says Stephen Hinshaw, Ph.D., a psychology professor at the University of California, Berkeley, who has studied ADHD for more than 20 years. In girls and women, the disorder is most often marked by inattentiveness, so parents, teachers, and co-workers may fail to catch it. Instead of coming across as boisterous and unruly, many girls with ADHD seem shy, lazy, slow, and unmotivated--"descriptors that tend to blame the woman or the girl," Hinshaw says.

Many young women are quick to absorb that blame. Having ADHD is nobody's fault; researchers say the vulnerability to it is genetic. But perhaps because girls tend to be more introspective than boys, Quinn says, they're more apt to admonish themselves for always feeling so chaotic.

Living with ADHD seems to be especially hard on females. The destructive impulsivity of the syndrome, Quinn says, can lead to such outcomes as unplanned pregnancies, job hopping, and botched relationships, as well as more-pernicious issues like diminished self-esteem and depression. A study published in The British Journal of Psychiatry followed 208 kids with ADHD into adulthood and found that girls were twice as likely as boys to be hospitalized later with mental illnesses, almost seven times as likely to develop schizophrenia, more than five times as likely to be diagnosed with mood disorders, and 18 times as likely to abuse drugs or alcohol.

According to recent research done on both women and men, adults with ADHD are twice as likely as their unaffected peers to have been divorced by their mid-30s and three times as likely to have been fired from a job. They are also more likely to have car accidents and sustain injuries. About 35 percent don't finish high school, four times the national dropout rate. Only 22 percent attend college, and only 5 percent graduate.

"We're the ones sitting in the classroom getting overlooked by the professor, who's thinking, 'Too bad she's so unfocused,'" Majerowicz says. "We're also the ones making terrible decisions about relationships, always dating bad boys who turn out to be jerks. And we're a financial mess, unable to balance the checkbook or even find the bills we have to pay."

Yet for all the burdens a woman with ADHD carries, she frequently doesn't realize she needs help. Since people with the condition often have a hard time monitoring their own behavior, it's usually a spouse, co-worker, or boss who is first to pick up on the problem, says David W. Goodman, M.D., assistant professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine. He or she may notice a pattern of disorganization, procrastination, failure to complete tasks, and spaciness. Or quirky habits may tip friends off: difficulty waiting in line, showing up on time, or letting others finish sentences. In any case, a psychiatrist can confirm the condition.

Once diagnosed, many women find that stimulants such as Ritalin or Concerta help them focus. Small behavioral adjustments--using an electronic organizer, making to-do lists, and writing reminders on sticky notes--can also bring some order and a measure of control. There are even ADHD coaches who will call clients regularly and remind them to complete tasks. (They're useful but expensive, Goodman says, costing anywhere from $50 to $250 an hour. To locate one near you, try www.coachfederation.com.)

Such changes, big and small, can alter life dramatically, as Majerowicz found. Soon after she started treatment, her productivity soared; instead of struggling to handle five to six clients, she now juggles more than 30 with aplomb. The difference shows in her bank account, too. She brings in nearly five times her previous income while caring for a new baby to boot. Danielle is also excelling, making good grades, waiting tables after school, and practicing for the cheerleading squad. "Danielle says I'm a better worker, better mom, better person," Majerowicz says. "I'm so happy we both figured out what this was and took control."

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By Suz Redfearn

Edited By Laurie Herr

do you have it?
If you answer "yes" to at least five of the following questions, contact a psychiatrist who specializes in ADHD and get an evaluation, says David W. Goodman, M.D., of Johns Hopkins University School of Medicine. Call the American Psychiatric Association at 703-907-7300, and ask for the number of your district branch, which can refer you to a nearby specialist. Before seeing a doctor, you may also want to try the Adult ADHD Self-Report Scale, a checklist of 18 questions, at www.med.nyu.edu/Psych/training/adhd.html.

Have you always taken longer to get things done than other people?
Are you highly distractible in conversations or when working at a task?
Are you fidgety, or do you have difficulty sitting still?
Do you tend to daydream?
If you've answered "yes" to the questions above, are these experiences you've had throughout your life?
If friends or acquaintances were taking this test for you, would they answer "yes" to most of the questions?
Do you have an immediate family member with the same chronic symptoms?

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