Sunday, December 4, 2011

Things I Wish My Patients Knew-Can Adults Have ADD?

I think they can. In fact I think I have some of it-the tendency to be easily distracted by details, to let my mind wander even in the midst of a critical conversation, and to have chronic difficulty tracking with a lecturer. I've learned to work around it, to keep good notes, and to ruminate information and manipulate it in my brain so I can remember. Since I've been reasonably successful academically I know that having some ADD tendencies does not neccessarily make a diagnosis or guarantee failure at life. I'm not significantly impaired by it.
However,research into the neuroscience of ADD clearly confirms the presence of a brain disorder that trumps dismissive diagnoses like "lack of willpower". Studies convincingly show that the cluster of symptoms called ADD can and do have a powerful impact on the lives of adult individuals just as they do on children. The majority of children who are diagnosed with ADD do not grow out of it, and have persistent dysfunction as adults. But for some reason we (general public and doctors) are more dismissive of folks who just "can't seem to get their act together".
The price to those adults who actually have ADD  is steep. They are much more likely to drop out of highschool (17% vs. 7%), to not obatin a college degree (19% vs.26%), and are more likely to have been fired or  to be unemployed. When compared to age-matched controls they have a higher rate of teen pregnancy (37 fold increase!), higher divorce rates ( 28% vs. 15%), and higher rates of both motor vehcile accidents and DUI. There are also significant mental health consequences- higher rates of depression, social anxiety, and alcohol and substance abuse.
Not to say that all adults who have some of these troubles have ADD. But a significant number of them do, and treatment may be life-changing for them. This can be one of the most rewarding aspects of practicing medicine-to help diagnose, and then to successfully treat, a condition that has nearly ruined someones life.
Do you have it, or know someone who may have it? Here's a useful, nonbiased website that has lots of  information:
The bottom line is that not everyone who lives a disorganized life or who does not listen well neccessarily has something wrong with them. And many who may actually qualify for the diagnosis of adult ADD based on testing are not signifcantly enough impaired to need treatment. But some ADD adults live tragically impaired lives which could be made so much better with proper diagnosis and treatment. I just wish they knew!
John K. Frederick, MD


  1. Dr. Frederick,
    Being non-diagnosed myself, I think success might depend on our ability to hyperfocus on things that are beneficial to us. If something makes sense to me, if there is a use for it, I have an almost photographic memory for it. If it is learning to learn, I struggle. Sometimes I think my house would be cleaner if I wasn't blessed with inattentiveness. (By the way, there is a "K" missing from Knew in the title).

  2. Dr. Frederick,
    Is the best treatment medications or do you suggest otherwise. I was just in your office as I am the marketing director/catering manager and part owner of Dickey's Barbecue pit at Sunset Valley and I happened upon this blog while searching out an e-mail address to offer to bring you and a couple of the lunchtime decision makers a free lunch sample platter from Dickey's. If you want the free lunch or want to answer my question e-mail me at I have history of depression, substance abuse {17 years sober now but struggle with keeping jobs and everyday tasks due to attention span difficulties. Thank you, Kimber