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Well, there ya go.

Still, I think we can all agree that kids should be competently diagnosed before taking a medication for anything—and then carefully monitored.

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I wonder what percentage of people who walk into a doctor’s office claiming to be in pain are really just looking for a prescription for Oxycontin? I wonder how many people who claim to have injuries are really just trying to get disability benefits or win a tidy settlement from a lawsuit?

I’m sure there’s some truth in this article, but so what? That some people lie to doctors to get meds or benefits shouldn’t be news to anybody. And it certainly doesn’t mean there aren’t others who really do suffer from legitimate diseases or disabilities.

You’d think people would be smart enough to understand this. Wouldn’t you?

I still maintain the highest hurdle ADDers have to overcome is the notion, shared by many, that everybody—if they try— is able to control his/her behavior and that therefore ADD/ADHD is really a character flaw, not a neurological disorder. The very idea that all people are not fully in control of their wills is, to those people, damnable heresy.

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P.S. Ah, what have we here? Just across the hall, on another topic page, a recent post from a woman in or from New Zealand (I presume). She calls herself “blondeADDkiwi”:

“[…] I hate being this way. ” she says. “Just out of the blue something will annoy me or “set me off.” I can’t control how I feel. I hate being this way. I just want to get on with life instead of pacing and procrastinating about starting or getting a job done. It’s soul destroying!! “

That pesky soul. It appears I’m not the only one who can’t get it to fire on all cylinders. And while we could have an online food fight over what a “soul” is—or if it even exists, can we stipulate that there is an elemental part of the human psyche that makes us unique as a species, a place within where our wills and urges collide, a place from where love, hope, and dignity emanate?

ADD/ADHD, as manifested in many of us, eats away at that “place” every day. Use whatever words you want, but watching in horror as our very humanity comes under constant assault is what we’re talking about.

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Angry? Moi? Not so much. Frustrated? Sure. Dispirited? Often. But angry? Only when I do something REALLY stupid.

And I don’t know why people react so strongly to the “cancer of the soul” comment. It derives from a definition of ADD offered by Thomas Trilling, son of the famous New York critic Lionel Trilling. In an extremely well-researched and compelling article about ADD in the American Scholar (the best piece for laymen I’ve ever read on the subject), he defined the disorder as “a neurological (or physical) impairment of the moral will.” That assessment rings true to me. It certainly speaks to my condition. It seems to me that Trilling’s definition and mine are roughly analogous. Now, you may not agree with the premise. Fine. But I can tell you that if you read enough posts on this site, you’ll see that I’ve got plenty of evidence on my side. There are many, many people here who, because of their own impulsive and/or compulsive behavior(s), find themselves in a personal hell.

In any event, it’s not a rant. It’s an observation.

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Ahem…. not EVERYBODY thinks monarchy is obsolete. There was an article in “Le Figaro” just a few days ago about the several monarchist parties in France. Many Japanese seem to love their emperor. There is a Russian Monarchist Movement, and even a Monarchist League of Canada! And that’s just for starters.

You just think they’re all… CRAZY!!

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Librarian_chef: you make a great point. Maybe we’re talking about apples and oranges here. If that’s true, we’re in the wrong forum.

As I have said before, I understand the upside. I personally have been extremely successful by the lights of others over the years—I’ve invented and brought to market innovative products. I’ve founded and run international businesses. In fact, I’ve been places and done things most people can only dream of. But, as you have suggested, it was partly luck; and with that “success” has come considerable collateral damage to myself, my personal affairs, and my family.

Others in my family with ADD struggled daily and left nothing but wreckage everywhere.

It has been said that people’s strengths are their weaknesses. And vice-versa. I think that’s generally true, and often true of ADD. We’re very creative. We are innovators—sometimes. Some people with ADD become Hollywood stars or find there way into Wikipedia. Hey, some people win the lottery, too.

Once, several years ago, a saw an adaptation of R.L. Stevenson’s “Dr. Jekyll and Mr. Hyde.” In this film, Hyde is not deformed or ugly. He is handsome and charming. I thought, “How brilliant!” Charisma and “creativity” also can be projections of a dark, menacing inner shadow. And, in fact, the tragic end of the story remained unchanged.

I won’t bore anybody with my life’s story. But I’ll say this: all the success I’ve had as a result of a creative streak (and luck) has been conjoined with other debilitating personal issues. And the tradeoff is not one I chose. It’s one I inherited. To be honest, even with “the upside” I’ve had the good fortune to experience, I don’t think I’d ever wish ADD on anybody. Swapping self control and neurological equilibrium for “magical thinking” is, in my experience, a Faustian pact.

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With all due respect—and I really do see the merit in positive thinking— it’s not about “normalcy,” it’s about functionality.

I’m all for redacting “normal” from the English lexicon when it comes to the human personality. And kudos to paradigm-changing innovators! But when you can’t perform essential everyday tasks, hold down a job (or keep from gambling away your paycheck), do your schoolwork, or maintain important relationships, you’ve got a serious problem. So does your spouse/partner. So do your friends, your parents, and/or your kids.

I doubt many ADDers change the world*—except to inject more chaos. In fact, if you believe what they say in their posts, they spend much of their time grappling with failure. If ADD/ADHD is just a benign personality trait, or a gift, why invest the money and research facilities to develop new, more effective meds? Why waste the money to produce a TV documentary? Or why have a website? Heck, save the bandwidth.

________

*Unless they also have sky-high IQs.

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Caravaggio!

I mainly wanted to congratulate you on a brilliantly apt handle for an angry ADHD sufferer. The great Italian artist was brilliant but tormented. He was a compulsive gambler and had a terrible temper. Maybe he was ADHD himself. Actually, I’d bet a dollar he was. In any event, he had to get out of Rome in a hurry when he got mad and killed a man in a brawl (turns out he also was an accomplished swordsman). He fled to Naples, then Malta, where his temper got him into trouble again. In 1610, at 36, he died of an illness (malaria?) on a beach near Naples, trying to make his way back to Rome. So Caravaggio II, if you’re 41, you’re living on borrowed time.

ADHD can be nasty stuff. If your life is in shambles, you’re not its first casualty. It may not make you feel any better, but this forum is full of stories of spectacular dysfunction. One sordid tale after another. I think ADD/ADHD is a cancer of the soul. Others here disagree. I think it’s very difficult for ADD/ADHD people to love other people or themselves. Others here disagree. The fact is, we don’t agree on a lot of things. But there does seem to be a consensus that ADHD makes life extremely difficult—for you and your family. There are meds you can try. Maybe they’ll help. Maybe not. But you need to work on the anger; it just takes up a lot of room in your psyche, and it doesn’t pay rent. Besides, we don’t want you to end up like up like Caravaggio I.

So what happened to Burgess Meredith in that Twilight Zone episode? It’s been a long time…

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Rick (or Thom) has nailed it. As has Dustin.

But I think ADD/ADHD or not, entrepreneurs need to be careful always to work ON their businesses and not succumb to the temptation of spending too much time working IN them. It seems to be universally true that it’s (much) harder to grow a business than start one. You have to shift gears. And it requires developing a different skill set.

That said, I think more ADD people should consider some sort of entrepreneuring, including microentrepreneuring, as a career. As businesses continue to focus on increased productivity, companies are hiring fewer people in middle management; and those “lucky” few frequently need constantly to be on task , deadline oriented, and willing to work on tedious projects for long hours—not a recipe for ADD success. Several people on this site have said they feel “unemployable.” I don’t doubt that’s true, particularly in this economic climate.

What ADDers CAN contribute is strategic vision and creative solutions to difficult problems. While there are a few job descriptions that list those bullet points as priorities, vision and creativity are both intangibles. It’s hard to convince a hiring manager you’re more “visionary” than some uninspired moron waiting in the next room—unless you’re Steve Jobs or Mark Zuckerberg, in which case you don’t need a job.

Let’s face it: if you’re ADD and looking for a job, it can be dispiriting reading the job listings. You see “keen attention to detail” or “able to produce weekly reports,” then gulp, and hit delete.

Entrepreneuring is not easy. And there’s always the problem of capital. But … if you know you’re smart and think you have a great idea, there are people out there who can help you with the details and offer helpful advice. You don’t have to be able to do everything–at least not for long. As long as you know your shortcomings, are willing to take ownership of them, and can find a way somehow to mitigate them, you’ve got a shot. Just remember to ask your spouse before you hang out a shingle!

BTW: I suspect there are a number of ADD entrepreneurs on this site who would be more than happy to offer specific advice.

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“Failure is success deferred.”

I like that. From Ray’s lips to God’s ears….

There’s an old joke: “I’m not afraid of of flying, I’m afraid of crashing!” I suspect that’s what many ADDers are afraid of—crashing (not success).

With the job market in the tank, some economists think entrepreneurial start-up numbers will continue to explode, out of necessity. And, once again, there’s an ADD irony here: We have lots of good ideas. But ideas require action—consistent, competent execution—to become reality. That’s why when we look inside our psyches we get nervous. But, hey, the people who OUGHT to be nervous are the hard-working, highly focused, steady-as-she-goes people who have a terrible business idea or no ability to respond to a quickly changing marketplace. If there’s one word that defines the 21st-century economy, it’s velocity—velocity of information, velocity of innovation, velocity of change. And it’s a lot easier to find help that’s focused than help that’s really savvy, creative, and quickly able to connect the dots.

Now, if we can just convince hiring managers of that, too….

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Apparently not.

It’s all confusing. No question about it. Unfortunately, it turns out that the chemistry of the brain is extremely complex. Doctors and researchers are still learning. Because of that complexity, it’s not always easy to arrive at accurate diagnoses. And it’s not always easy—or apparently even possible—to find treatments that provide real relief for many people.

Maybe before too long researchers will come to a better understanding of the neurological underpinnings of ADD and bi-polar disorder. Then, armed with a better grip on the organic chemistry, perhaps they’ll find newer and better ways of mitigating the myriad, sometimes contradictory symptoms of these afflictions.

In the mean time, I guess we commiserate. We hope for rapid medical progress. We try various hit and miss therapies. We try to muddle through.

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Cayjam–

Just curious: Were you late to work because you overslept? (You mentioned that you had sleep issues.) Or because you just didn’t organize your morning schedule?

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What a curious comment.

From an introduction to “A qualitative study of Australian GPs’ attitudes and practices in the diagnosis and management of attention-deficit/hyperactivity disorder (ADHD).” Authors: K Shaw, I Wagnera, H Eastwood, and G Mitchell

“Attention-deficit/hyperactivity disorder (ADHD) is a behavioural syndrome where inattention and/or hyperactivity impair social, academic or occupational function. Although the aetiology is still largely unknown, there is less evidence to support social and environmental causes than those that are neurobiological or neurodevelopmental in nature. Genetic factors, neurotransmitter abnormalities, cerebral glucose metabolism anomalies and frontal lobe abnormalities have all been implicated as possible causes of ADHD.

Estimates of the prevalence of the disorder vary according to the sample population’s location, age and gender distribution, and the diagnostic criteria used to assess ADHD in different countries. Worldwide prevalence is estimated to be between 1.7 and 6.7%. The disorder is 4–9 times more common in boys than girls. Approximately 65.0% of these children will have one or more co-morbid psychiatric or disruptive behavioural disorder. If left untreated, the long-term prognosis is poor. Manuzza et al. described an 11-fold increase in ongoing ADHD symptoms, a 9-fold increase in antisocial personality disorder and criminal detention, and a 4-fold increase in the rate of drug abuse in unmedicated sufferers compared with medicated controls.

In many countries, the importance of primary care involvement with ADHD is increasing due to the rising numbers of patients who present with the disorder. (Various references redacted)

So Australians see it. And it appears a few Canadians do, as well. Ironically, I know a Ukrainian family that suffers terribly from it.

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After reflection, another observation:

Perhaps these stats reveal something more fundamental about the way American healthcare works today.

Until the 1980s, pharmaceuticals in the U.S were promoted exclusively to doctors. Then something happened. The following excerpt is from a piece on NPR (America’s National Public Radio) in October 2009:

“… [Until the 1980s] doctors exclusively held the keys to the kingdom, drug companies spent enormous amounts of time and money trying to get their attention. To give you a sense, the average doctor got around 3,000 pieces of mail a year from the drug industry, and to break through this noise often took years.

And so [Joe] Davis, who had previously only sold packaged goods, approached William Castagnoli, the then-president of a large medical advertising company. The two came up with a solution: They would advertise directly to the patient. They’d get the patient to go in and ask the doctor for the drug. “Pull the drug through the system,” Davis says with a certain amount of glee.

There was only one small problem with this solution: It was almost impossible to do.

In the early 1980s, FDA [the Food and Drug Administration that oversees all prescription medications in the US] regulations required that drug ads include both the name of a drug and its purpose, as well as information about all the side effects. But side-effect information often took two or three magazine pages of mouse print to catalog, and this wouldn’t do for a major television campaign. As Castagnoli says, “We couldn’t scroll the whole disclosure information over the television screen — OK?”

But then, in 1986, while designing an ad for a new allergy medication called Seldane, Davis hit on a way around the fine print. He checked with the Food and Drug Administration to see if it would be OK.

“We didn’t give the drug’s name, Seldane,” he says. “All we said was: ‘Your doctor now has treatment which won’t make you drowsy. See your doctor.’

This was one of the very first national direct-to-consumer television ad campaigns. The results were nothing short of astounding. Before the ads, Davis says, Seldane made about $34 million in sales a year, which at the time was considered pretty good.

“Our goal was maybe to get this drug up to $100 million in sales. But we went through $100 million,” Davis says. “And we said, ‘Holy smokes.’ And then it went through $300 million. Then $400 million. Then $500 million. $600 [million]! It was unbelievable. We were flabbergasted. And eventually it went to $800 million.””

Clearly, the introduction of pharma TV advertising had enormous implications for drug companies’ bottom lines, but it also revealed something interesting about the doctor-patient relationship: Clinicians were willing to give their patients what THEY wanted. All they had to do was ask.

So, if up to a million kids are being “over-diagnosed,” it’s likely—in large part— because parents are ASKING for the diagnosis, and therefore for the meds, hoping that their youngsters will sit still and do better in school.

If adults are being under-diagnosed, it’s probably because pharma giants haven’t yet figured out how to get information that resonates out to that demographic.

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Interesting indeed.

But consider: A parent, armed with information gleaned online, walks into a pediatrician’s office and says, “I think my child may have ADD.” The pediatrician has, what?, seven-ten minutes to spend with a patient? So he/she asks a few questions and says, “Hmmmm. Maybe you’re right. I’ll prescribe some ‘XYZ,’ and we’ll see if that helps.” At that point the doctor moves on and it becomes up to the parent to make (in many instances, confirm) his/her own diagnosis based on what she observes at home, or thinks she observes, after the child starts taking a medication (the trial-and-error approach). With doctors overwhelmed by patient workload, forced to prioritize based on the severity of illness, and staggered by the vast quantity of new medical research/information coming at them like a freight train (information that needs to be assimilated), it’s amazing they can function at all. Frankly, under these circumstances, it’s hard for me to imagine that millions of patients aren’t misdiagnosed annually for all sorts of things.

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