My symptoms are not minimal. I’ve exhibited these symptoms since early childhood. I easily meet the American Psychiatric Association’s DSM-IV diagnostic criteria for the predominately inattentive type of ADHD. Had I simply just taken one of the many available self tests such as the one offered by the Amen Clinic or this one by Dr’s. Hallowell and Ratey I would have certainly gotten professionally evaluated sooner. What happened?

The Three Biggest Reasons for not Suspecting ADHD

1. Until the 1990s ADD/ADHD was considered a childhood disorder that usually resolved itself by adulthood.
2. Until even more recently ADD was considered to be much more common in boys than in girls.
3. The most typical “presenting problem” leading to a referral for an ADHD evaluation is the disruptive behavior (fidgeting, difficulty staying seated, talking incessantly) more commonly associated with the hyperactive type of ADHD.

Contributing Factors

1. People who have ADHD are particularly poor at self observation. Although we too often readily accept and internalize the labels applied to us by others “unmotivated, lazy, scatterbrained, space cadet, underachiever” we’re not as adept at seeing and labeling ourselves. As the correlation between these types of labels and the diagnosis of ADHD becomes more widely understood I think externally initiated labeling will cause more individuals to suspect this condition in themselves and hopefully seek evaluation and treatment.
2. Most people who seek treatment are in pain. Emotional pain often leads to or can be interpreted as depression. My experience with therapists and medical professionals is that depression is a red flag. The potential ramifications of untreated severe depression, i.e. suicide or self-violence, draws their focus like a magnet. I have been told by many professionals that depression and anxiety are frequently associated with adult ADD. (Gee, I wonder why). My concern is that professionals tend to focus on the depression and may miss the ADHD diagnosis and/or fail to provide assistance in addressing the patient’s ADHD issues.
3. Many teenagers and adults with untreated ADD/ADHD unknowingly attempt to self medicate with tobacco, alcohol, or other drugs. As with depression these substance issues are seen as the primary problem and the underlying ADHD issue can be missed.

Some Suggestions For Ensuring the Proper Diagnosis of ADD/ADHD

• Upon making or receiving a diagnosis of ADD/ADHD in one family member – siblings, parents and children of the patient should also be evaluated whenever possible.
• Educators should be trained to recognize the symptoms of the inattentive type of ADHD – under-achievement, poor organizational skills, inconsistent school performance, day dreaming, and poor social skills – particularly in otherwise gifted children.
• Professionals and agencies working with substance abuse cases should routinely screen for ADD/ADHD to determine whether the abuse is linked to self-medication.
• Patients dealing with depression should always ask to be screened for underlying conditions which may have contributed to their depression.

My inability to maintain attention must result in a somewhat different understanding of cause and effect. If I missed 20% of the information because I was daydreaming does my brain compensate by “creatively” filling in the blanks? Is this what leads to “out of the box” thinking?

Alternately does my flitting from thought to thought, or distraction to distraction, result in my making connections between ideas which are not normally associated in nature?

Brain imaging technology – EEG, MRI, and PET, CAT and SPECT Scans – suggest that ADD/ADHD causes reduced brain activity particularly in the pre-frontal, executive control center of the brain. Go to brainplace.com to see some of these pictures.

If ADD results in reduced brain activity is creativity the result of some form of streamlining capability? Or do these scans only capture a portion – the organizing, controlling portion – of brain functioning; and do other processing capabilities lie elsewhere?

Today I guess, I’m just asking questions.

• why I wasn’t diagnosed until I was 49 even though my son had been diagnosed eleven years earlier
• why I hadn’t been able to diagnose myself despite reading numerous books and articles on the subject after my son was diagnosed and during the intervening decade
• why with an estimated 3-8% of the world’s population having ADHD it is so misunderstood by medical professionals, educators and the public at large
• why a disorder which causes significant pain and suffering is frequently called a “gift” or a “myth” and serves as the basis for numerous comedy routines

ADHD is an enigma. And if someone had just told me that forty years ago, I would have known what I had all along.