Nieman: ADHD not just a childhood issue

Very often when I see a child referred to me for an ADHD (Attention Deficit Hyperactivity Disorder) assessment, a parent starts laughing when I ask, “Have any of the parents been diagnosed to have ADHD?”

The reason for their laughter is that frequently the mom and child tell me about the father who supposedly has all the symptoms of ADHD, but it has never been diagnosed. Of course, it can be the other way around also where the mother may be the adult in the family who has ADHD which remained undiagnosed.

I am usually told that the parent of my patient may be losing things easily, always seem to be on the go, suffers from forgetfulness, is easily distracted, is prone to procrastination, making careless mistakes and is unable to finish tasks.

These symptoms are rather general and many adults, at times of fatigue or stress, may exhibit these features.

Dr. Ed Hallowell became famous when his book Driven to Distraction became a New York Times bestseller. Hallowell has ADHD which was never diagnosed when he was a child. That created a lot of suffering along the way, and he explains how it may be a miracle he was able to become a doctor.

Hallowell also coined the term “Attention Deficit Trait.” He argues that almost all adults are prone to some degree of inattention, depending on their circumstances.

A prolific author, Hallowell has become one of the go-to experts regarding ADHD in adults. His website www.drhallowell.com?provides numerous resources for adults who wonder if they may have ADHD or not. He also hosts a popular podcast,?Dr. Hallowell’s Wonderful World of Different.

Another useful and well-respected resource for those who want to research the possibility of undiagnosed ADHD can be found at CADDRA (Canadian ADHD Resource Alliance) On the website (www.caddra.ca), there is a checklist to answer questions, specifically for adults.

In many of Hallowell’s writings and on www.caddra.ca, we are reminded of the consequences of undiagnosed and under-treated ADHD. It impacts families. Because ADHD is so often undiagnosed in adults, the impaired quality of life affects not just the patient/parent, but a wider community.

Some experts argue that the ubiquitous use of electronic devices and excessive screen time has altered our neuropathways and made an increasing number of adults more prone to inattention. The jury on this matter is still out. Training the brain to multitask and jump from one object to another rapidly may cause new neuropathways.

(For more information on how meditation changes our brain, and help in the management of ADHD, I highly recommend Danial Goleman and Richard Davidson’s book?Altered Traits.)

A recent story about a parent being inattentive will stick with me for a long time. After 35 years in the same location, my clinic is relocating to a new address. We prepared our patients via more than one email telling them the move will happen in July 2023. In early June, an angry father called our office wondering why we were not at the new clinic and what happened to us. When he was told that the email specifically said we are making the move in July, he started to argue. One can only speculate about the possible causes of his lack of attention to detail.

My concern about ADHD, both in adults and children, is the fact that it is both under and over-diagnosed. The terminology also leaves a bitter taste in my mouth. Who would like to be labelled to have a disorder? Selective or situational inattention seems to be a better way of describing this controversial issue.

I often see how a child in my office, there to be assessed for ADHD, undergoes a change in body language. Instead of focusing on what is wrong with him or her, I focus on what the child is good at. Very often we hear that the child has a great sense of humour and a vivid imagination which helps him or her be creative. A vast amount of energy enables many patients to be very productive.

Not so long ago I listened to a well-known photographer in his art gallery talking about how bad he felt as a child when he was told he had ADHD. He, too, did not like the term “disorder.” It impacted his self-image. Today, he does what he is passionate about — he paints with light. His photographs sell for thousands of dollars, and he explained to me that he has ADHD to thank for that.

Dr. Nieman is a community-based pediatrician. See www.drnieman.com